HomeMy WebLinkAbout6575 ROOKERY RD - APPLICATIONS - 6/21/2005BUILDING 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 P2/ / b 2 t L 6 APPLICATION DATE A - of
Job Site Address & S J:S 1Zm�CQ.c " '20 , Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 3-4 4 �1 _3
Last Nam6'�� L1 � o. First Name Middle
Street Address Sa,,� cas o�bov� City r ems State_,Cjnk_Zip 865cM
CONTRACTOR INFO: Company Name d►k r s t, \\tom Contractor Phone # �46� �63fl
Lic. Holder Name'a7ac.\\ C��,ro.\o...o� City of Fort Collins License # C-a Supervisor Cert#
Mailing Address city," State Go Zip P�c>S;aLj
LEGAL INFO:
Subdivision/PUD '�osS.\ \���� Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq Ft,
1st Floor Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units ` 1
_ Unfinished Bsmt Sq Ft y I :5' Finished Bsmt Sq Ft I SI S i�
# of Bedrooms # of Full Baths 1 1/4 Baths '/z Baths # of Fireplaces (\(\
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
4. E-Star w/Blower Door
5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Si
ze (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ - 56
Description of Work:'a.Inl ,,.\\ %, -V� ; "s l' -P—x -6 ."
Contact Name & Phone # of JOBSITE SUPERVISOR:-"�wr,_),N
Subcontractor Info:
Ci
Electrical (1��\_, Mechanical C:5CA Plumbing -bl—
Framef?-, _.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 Signat Print Name oc�\\ �rn�.o ...i Phone y9 3 SG 3
Distribution: hite — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE