HomeMy WebLinkAbout4700 INNOVATION DR - APPLICATIONS - 1/18/2006City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www fcgov com/building ATM:
BUILDING PERMIT APPLICATION AlW% AMO
APPLICATION NUMBER APPLICATION DATE_ I I I FSI D I/
Job Site Address g7vo tivavv/monj #>It..I N*A GI FT- GOwrNc Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # a%y - 2-09 - t 00
Last Name 1>R,P oT71k First Name_ np;ff t/ Middle U
Street Address If 70D 3:"NOVAgjotr D►� gt4>,A G City F''1- Go&4,INs State li Zip 9
CONTRACTOR INFO: Company Name DR,od•YOTp� Contractor Phone #
Lic. Holder Name City of Fort Collins License # 4• 1 -- (3 Supervisor Cert # v
Mailing Address 14700 SNNOVAcnoN t>K.i N'w.4G City FT GoW/NS State e--,O Zip �505?�
LEGAL INFO:
Pi.*T Fiw, No. -1 sN-(%
Subdivision/PUs Plogf-K 17 Filing # Lot # 25' Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 0)&3 ` e Aggw) Total Garage Sq Ft NI
Residential Sq Ft Comm'I Sq Ft I3V•> # of Stories—�— Bldg Height # Dwelling Units
1st Floor Sq Ft 13fi3 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms
Air Conditioning: es No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
# of Full Baths '/ Baths Y2 Baths ( # of Fireplaces
1 omCheck 2. ResC eck w/Air Sealing
Energy info: (Circle appropriate choice) V'
Nl��Xtsnrva rwlf,+eslNa� �.
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s __ \
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or &°
Type of Heat: 1�(Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 2-So 000. 00
(rwrv1-WIF)
Description of Work: TF-Np-/N f FI N ( slk d F Kx t5?1NG ffwn/ 5wr' At.1jfN L• '� d FFI pas
PLMA,% It> 1400AA
Contact Name & Phone # of JOBSITE SUPERVISOR: �/1,Or�/ W^✓1�1�7/` G�'?0.- ��_ 0�✓V
i
Subcontractor Info:
Electrical AP-0"ft 0:L,0,r-1ZIG Mechanical Aq p- "mf%i IT Plumbing LiNW S
Framer Roofing NLA- Concrete 14%Ac Other
Applicant: I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature f/l 011<L Print Name_ - VVi4 _ Phone 4170-7-0N-0100
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE