HomeMy WebLinkAbout411 E PITKIN ST - APPLICATIONS - 3/29/2006APPLICATION NUMBE
Job Site Address
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION
J
1�3— Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # 31i�,-I-� 1
Last Name First Name II j Middle
Street Address I� G.•-� City �� �l 1�✓� StateC� Zip
CONTRACTOR INFO: Company Name
Lic. Holder Name
Mailing Add
SubdivisionlRUD
Contractor Phone #
City of Fort Collins License #.
City
Filing # Lot #.
Total Building Sq Ft (not including basement)
Residential Sq Ft
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Comm'I Sq Ft # of Stories
Supervisor Cert #
State zip.
Block # Lot Sq
Total Garage Sq Ft
Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
f Full Baths 1/4 Baths '/2 Baths # of Fireplaces
En y info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing \
4. E-Star w ower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door \I _
List appropriate option
Water Tap Size Sewer Tap Size '\ Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker SiN (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & pr(ofiCt)1 $_ �, 0j� f ` t 1 _ r
Description of Work: rpf igy- r S �1,vt," t hCY�Q _ Dr•-rh 01 11611 � `i t ( �tv�
Contact Name & Phone # of JOBSITE SUPERVISORJ- — tom. 3(Q,— (el 7 )
Subcontractor Info:
Electrical Mechanical Plumbing
Framer RoofingfS 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 c col IrN Phone 3ta-LI71
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE