HomeMy WebLinkAbout613 MEADOW RUN DR - APPLICATIONS - 9/14/2005BUILDING 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 APPLICATION DATE
Job Site Address (fi 3 /lit >yaj %.Lpj Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Z? 8Z- ZAI
Last Name 1 11 AA-) &IL-I-n First Name bC-i Middle
Street Address to13 piel}IDo �L1/J bk. . City ri GLLI.JS State `Cu Zip f�OSz.S"
CONTRACTOR INFO: Company Name (AiL Wt jC-- �.15% . ��C • Contractor Phone # =7 yT 9(e
Lic. Holder NameJ L � I./oA ,,-x,- City of Fort Collins License # Z' S-O Supervisor Cert # Z Z
Mailing Address 110. L00k0Q7- 4�,W 0 City )FE—. COLLi^-)s State Co Zip ROS Z-4
LEGAL INFO:
Subdivision/PUD L, kk b'1¢DOt,1 (o A�li?Ai✓hW% Filing # /Sr n` Lot # Z(7
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft
l s' Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Block # Lot Sq Ft
Total Garage Sq Ft
Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft�Finished Bsmt Sq Ft 6&41
# of Full Baths — % Baths I 'Y2 Baths
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option #s
# 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
Value of Construction (including labor, material & profit) $ Z-S (.(G0.00
Description of Work: H-t,alSN I SSA I ,i 'T = /,%1CLU0g- / ^j -T 4 8 �
� 1 U t wJ (� lQd � r✓I
Contact Name & Phone # of JOBSITE SUPERVISOR: :Smay, jb—A,0Jl,.1(r Z2 7-ggq
Subcontractor Info:
Electrical,V0u,-J?*A1 1 tM 5 Mechanical 1"d- QL IM-54 44rV/C-5 Plumbing &Q PLj--401,A--
Framer S 4= .F- Roofing fV 1,4 Concrete nl JA 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 Cityyoof Fort Collins ordinances and state laws regulating building construction.
Applicant Signature Jtz /0%1G---3 Print Name STLEVE- LJLNWW(f Phone ZZ7'g41(0
Di ibution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE