HomeMy WebLinkAbout601 JUSTICE DR - APPLICATIONS - 12/18/2008BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
6Z www.fcgov.com/building
CityofFort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER O/ APPLICATION DATE i f U `/ U
Job Site Address 64/AeiuF Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 'lb �� '-i�s
NE/
Last Name G-�IVIVOL'.Li'l First Name �� Middle ��977-
Street Address 60 �C,cy-�iCE' , �iZJI%� City � [SDGI��%S State &-li ZipgK�Z4
CONTRACTOR INFO: Company Name �A Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address
LEGAL INFO:
City
State
Zip
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 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 3/4 Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No
3. ResCheck w/Blower Door
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
Description of Work: L CLc%L��L� �7�D � �� 7D A;ae 1,,',47
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical
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 and state laws regulating building construction.
Applicant Signature
Print Name Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE