HomeMy WebLinkAbout907 BUTTE PASS DR - APPLICATIONS - 2/2/2006BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.c fcgov om/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER &400-�(ky APPLICATION DATE ;t — 6;� 6 6
Job Site Address !aya ,a t :&ZPQ S S --p tr Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # a G
[� p c
Last Name ��LT�i� First
"N�ame 1 /��1( fiddle /o
Street Address`1f`m� \c�,t A. $ \�-2 .SS �_)rC City N- co \\ � vt 5 State -Ca Zip
CONTRACTOR INFO: Company Name V-,o"�actoor Phone # � i, - ,i6X-)15
Lic. Holder Name�sy'S City of Fort Collins License Supervisor Cert # tG
Mailing Address-1!�:K5er- City GO *-IS State eO Zip Zoo
LEGAL INFO:
Subdivision/PUDW �`` 3� Filing # Lot # Block # � Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1 sc Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft 1Z[Q Finished Bsmt Sq Ft
# of Full Baths % Baths 'h Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing +
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 No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size
i(Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ S �'
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR: �"� - s�.�/`\ Q-X-l-.f - C L>
Subcontractor Info: M � ( (��
Electrical c>tin ee-r Mechanical 1 e+, aj t' e-e-�Q ^k ' Plumbing
Framer
Roofing
Concrete
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 Print Name ' Phone�`��C�
Distributio White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE