HomeMy WebLinkAbout938 W MOUNTAIN AVE - APPLICATIONS - 3/23/2006a BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 0 APPLICATION DATE 3— o — 0 o
Job Site Address Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phoeene # v1119 - it,
Last Name ' A First NameGirv'l na IJay Middle IjA 11e,
n
Street Address "134 1j el mta /k' n he, City :a. C.�'1► A State � 0 : 31
` Zip -
CONTRACTOR INFO: Company Name AS (_,(��5k�� (�� Contractor Phone 410 - q77 — goo eC
Lic. Holder Name ,Qiiri City of Fort Collins License # (0 Supervisor Cert #
Mailing Address City i , , (()tll t-N S State LD Zip 2
LEGAL INFO:
Subdivision/PUD
Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Block # Lot Sq Ft
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 4 S pD
# of Bedrooms # of Full Baths % Baths '/2 Baths
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size
# of Fireplaces
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less
Value of Construction (including labor, material & profit)
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical �rl �lls k�1-Tlr`t //(��� Mechanical
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Framer 6 �r.(,Rob#ing
Concrete
❑ 200 Amp ❑ Other
-7d
Plumbing WA plumblf,6
Other
Applicant: I hereby acknow d that I have read this application nd state that the above information is correct and agree to comply with all requirements
contained herein and City F rt Collins ord'n nces and state la regulating building construction. Applicant Signature Print Name&10ffJ Phone ii
Distribution: White — Office Yellow — Applicant Pink — WWW tormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE