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HomeMy WebLinkAbout6713 HOLYOKE CT - APPLICATIONS - 6/5/2006,.; 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�P CJ �-�C S APPLICATION DATE Job Site Address T Unit # PROPERTY OWN/ER INFO: (All owner information is required - it is not optional) Phone # A\ /► Last Name C_ C ft K k y First Name D p kD onlalk y I Middle �{-• Street Address ? ►�10 �/ 0 ` e City �b� C8 /A it/ S State CO Zip F As ZJ Company Name Lic. Holder Name Mailing Add Contractor Phone # City of Fort Collins License # Supervisor Cert #. City Subdivision/PUD Filing #. Total Building Sq Ft (not including basement) Residential Sq r-:: Comm] Sq Ft, 1 s' Floor Sq Ft # of Bedrooms Air Conditioning: Yes No 3. ResCheck w/Blower Door City of Fort Collins Stock Plan # UTILITIES INFO: 2nd # of Full Baths State Zip Lot # Block # Lot Sq Ft, Total Garage Sq Ft # of Stories Bldg Height # Dwelling Units - Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft v _--iQaaths 'Y2 Baths # of Fireplaces Energy info: (Circle appropriate choice) 7-rDmCb0c 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing List appropriate option 2. ResCheck w/Air Sealing 91 Door Water Tap Size Sewer Tap Size Yes or No Temp. Pedestal: Yes or No Type of Heat: ❑ Gas ❑ Electric Electric Main Breake�Size Residential only): ❑ 150 Amp or ❑ 200 Amp ❑ Other alue f Construction (including labor, material & profit) $ .. Description of Work: �eCRg - -1 / D,-J 119R-r R&© M Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical —T-, S (e1 e c-t-Kj'G Mechanical G( 2 4 - t t u y) D/2 -)-u r" f2 c, 0619 f 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 ang state laws regulating building construction. Applicant Signature t3� /3ayaj Print Name 13tr47-F} 1) a 4 Phone S-� 6 —q (Zi Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE