HomeMy WebLinkAbout907 VANDERBILT CT - APPLICATIONS - 8/31/2009BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
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www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER V l O �� ! APPLICATION DATE a�'� Z21,
Job Site Address �j 1 V C-kt� &krQ .W� Ld j,� Unit #
PROPERTY OWNER INFO: (All owner information is required - it is notoptional) Phone # 9lo - 2,2-3^ SS
Last Name An V qyk.x First Name a d'V; Q 1 -174 pp ���� Middle C
Street Address 2 :2`- '--2),44 C� A) -DR, Lt city Va' T C--os�� �[lky--i State_c�$_Zip &S2 5
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holder NameCity of Fort Collins License #
Mailing Address
LEGAL INFO:
City
Subdivision/PUD C'14'6 uU.J6,6-k Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) i7� `50
r
Residential Sq Ft Comm'I Sq Ft.
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
# of Stories Bldg Height,
State
Block #
Supervisor Cert #
Zip
Lot Sq Ft
Total Garage Sq Ft
# Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths % Baths '/2 Baths # of Fireplaces
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
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only):
Value of Construction (including labor, material & profit) $
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Mechanical
Temp. Pedestal: Yes or No
� s •
or Less ❑ 200 Amp ❑ Other
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 Forrtt Collins ordinance and state laws regulating building construction.
Applicant Signature ,tad' �` Print Name. V O I T H C. � V A Ll Phone 910�- 2 a--- 6t
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE