HomeMy WebLinkAbout1422 N COLLEGE AVE - APPLICATIONS - 1/17/2006City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER '/ APPLICATION DATE
Job Site Address 14'.2.,2 )V. Unit # q
PROPERTY OWNER INFO: (All owner information is required - it is not optional) , Phone # q 747 ^ 2�2 r 3 O
Last Name 1--eg? 1 First Name k4'a, ry Middle lii4p%
Street Address / 7/o 14% City x . j�; &'e*1 Q State'C2 Zip D Z
CONTRACTOR INFO: Company Name S�rir� �!s i <�E'/S , ��� Contractor Phone #
q P
Lic. Holder Name �C--��''�/� f/ %%1�Pf/`PY' � -1 Cityof Fort Collins License # t3 /� Supervisor Cert #
Mailing Address Jr�3 /�e.5 / l�C� � /i'P�7 City 14a: � State e0laP-Aalc Zip
LEGAL INFO: MM�
Subdivision/PUD 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
1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option #s
6. Prescriptive w/Blower Door ��k
1v
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No �J
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other Q�
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Value of Construction (including labor, material & profit) $ '0!r' o?
Description of Work: - ell -v
Contact Name & Phone # of JOBSITE SUPERVISOR: ft/d5 f All 47 71 /- 9 �v ---� X/1 —10-5d
Subcontractor Info:
Electrical �''y'eeGF EleC-/y, C- Mechanical I Plumbing Nj�
Framer's l�o�/A -6111' Roofing � u Concrete � S Other
Applicant: I hereby ac nowledge 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 e /� Y�4f- D:�I?lel- Phone y /� —` /,
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE