HomeMy WebLinkAbout966 WAGONWHEEL DR - APPLICATIONS - 5/19/2006BUILDING 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 = l —f APPLICATION DATE
Job Site Address Unit #
PROPERTY/1 OWNER INFO: (All owner information is required — it is not optional) Phone # (2 1O 2 a 3 0Z S`%
Last Name �l _ Q-9— First Nam _ _ -- SKA Middle
Street Address Wo C City C�� State
CONTRACTOR INFO: Company Name �� Contractor Phone # Q� K 'Zin 3 3
Lic. Holder Name City of Fort Collins License #,
Mailing Add
City
Supervisor Cert #
State Zip
Subdivision/PUD Filing # Q Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 1 � 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 CNOD Energy info: (Circ�l p epriato choice) 1. ComCheck 2. ResChec`k w/Air Sealing
3. ResCheck w/Blower Door 4. E-wer Door 5. Prescriptive w/Air S g ti• Prescriptive w/Blower Door
City of Fort Collins Sto an # List appr option #s
UTILITIES INFO: _
Water Tap Size Sewer fiap Size Metered: Yes = No Temp. P e�fal: Yes or No
Type of Heat: as ❑ Electric Electric Main Brea a (Residential only): 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
Description
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical
Framer Roofing Concrete
Plumbin
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 Collin oAlances and state laws regulating building construction.
Applicant Signatur �!\Q Print Name . �C Y l� �G� u► Phone "l J
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE