HomeMy WebLinkAbout6802 NIMITZ DR - APPLICATIONS - 10/17/2012City
}of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collinsll281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221.6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER /-(/ APPLICATION DATE / O —ZI2
)(Ob Site Address 690a A11MITF l(CUnit # f} / 0 3
NfiROPERTY OWNER INFO: (All owner information is required -it is not optional) Phone # — o)o ) jy
Last name nn
_r i 14 P\-rj jyEC First Name W ILL/ Middle L)
Street Address TO A) a3 City ED q 1 CO L..L/ /U S State CD Zip R6,5v�
ONTRACTOR INFO: Company Name SELF Contractor Phone #
I
s Holder Name
Mailing Address
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO:
ng Sq Ft (not including
City of Fort Collins License # Supervisor Cert #
State
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm q Ft # of Stories Bldg Height #Dwelling Units
151 Floor Sq Ft 2ntl Floor S t 3rd Floor Sq Ft Unfiished Bsmt Sq Ft
Yinished Bsmt Sq Ft �� # of Bedrooms # of Full Baths 3/4 Baths /z Baths # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle propriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alte tive 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List ap3rQpriate option
Water Tap Size Sewer Tap Size Metered: Yes o No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only 50 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ P- �. ��
A _ / � ../ _ /? i
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Ilectrical M P k i T F LIECTR) C Mechanical
Framer
Solar
Roofing
Other
Concrete
Other
Plumbing
Fireplace
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.
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plicantSignature tXtt"aU �t "l( Print Name W14dINFG .90 LIAM J. Ik4APhone3-�9<--b�S3
/, Distribution: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE