HomeMy WebLinkAbout901 W MOUNTAIN AVE - APPLICATIONS - 9/21/2009BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
Cityof Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER L/ V �� APPLICATION DATE OG Z- DOq
Job Site Address G01 Ave, P.r05 90,JZ1 Unit#
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # q 4 4 3 0 9 S D
Last Name H O tfq � First Name � CL'-, C_ Middle JZ Ohe,1-45
Street Address q C Owh4e;6n Ave— City 1�_b /'I C n 1) 103 State CC) Zip 8 C) SZ i
CONTRACTOR INFO: Company Name tii 1A
Lic. Holder Name
Contractor Phone #
City of Fort Collins License #
Mailing Address City,
LEGAL INFO:
Subdivision/PUD �r�5� I ✓� 'Pla-ce— Filing # q
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) o I
Supervisor Cert #
State Zip
Lot # o2 ( Block #_L_ Lot Sq Ft (D, S Z -J
Total Garage Sq Ft iN/A
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths 3/4 Baths '/2 Baths
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option
1 .3
# of Fireplaces
2. ResCheck w/Air Sealing (�
6. Prescriptive w/Blower Door
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
/�.,l 00
Value of Construction (including labor, material & profit) $
Description of Work: lzr_.01cL ce, o(e c IL -b G ",,c/'eT4 codes mac(. r� r i r n rti
1-1 1 r a,. S-�.r l e. 1c.0-at. e c -t n S.
Contact Name & Phone # of JOBSITE SUPERVISOR: I VCR C Ll EIb Ll L{ 3 O l 5_6
Subcontractor Info: N) /A
Electrical Mechanical
Framer
Roofing
Concrete
Plumbing
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 NGL. nC y O LA-Gh Phone cl� �{LJ3 0 11D
tribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE