HomeMy WebLinkAbout612 ZUNI CIR - APPLICATIONS - 8/15/2006BUILDING 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 A �_ (l APPLICATION DATE O
1 --Job Site Address 61Z 2�'/// 614e-Lf Unit # g 7
—PROPERTY OAAW��NER INFO: (All owner information is required - it�iss nnot..00ptional) Phone # 303 t1/C� riZ Y jj�
Last Name /Y�LS6-First Name 7�N*11-w ` Middle 7. U • /
Street Address 44ir City State 64 zip 5�6 � 7 6
CONTRACTOR INFO: Company Name
Lic. Holder
Mailing
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
15t Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes
3. ResCheck w/Blower Door
2°d Floor Sq Ft
# of Full Baths
Contractor Phone
City of Fort Collins License # Supervisor Cart #
State
Filing # Lot # Block # Lot Sq
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
_ Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
i
- % Baths '/, Baths # of Fireplaces
No Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
City of Fort Collins Stock Plan It
List appropriate option
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
Water Tap Size Sewer Tap Size Metered: Yes or o . Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 0 Amp or
Less ❑ 200 Amp ❑ Other
;—Value of Construction (including labor, material & profit) $
_Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
Applicant: I hereby acknow a have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City Tins ordi n s and state laws regulating building ypnstructiopyF1 4,ll
✓-Applicant Signature Print Name M1WF Ak"V Phone (303� gl�-?-� Zy
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE