HomeMy WebLinkAbout4144 CENTER GATE CT - APPLICATIONS - 6/20/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort CollinS 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www fcgov conWbuilding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER - I A APPLICATION DATE.
Job Site Address _(J4LI_ _(2a& '.EaP C= Unit #
PROPERTY OWNER -INFO
:
/ (All owner information is required— it is not option) Phone #.. �" /� -- a g
Last name /J i.____ ___ __. __ - First Nani Middle
Street Address _ _ - _ City - _ S Stat Zip pp
CONTRACTOR_ INFO:. Company Name ontractor Phone #= "OOZO0
Lit Holder Nam City of Fort Collins License #C Supervisor Cert#
g ty_P1 l 0,U n)s State- Zip Mailio Address Ci
•
Subdivision/PUD l i . _ Filing Lot #0A Block #��.Lot Sq Ft.-1.S�7_ _
CONSTRUCTION- INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft.� Comm'I Sq Ft t/ # of Stories Bldg Height # Dwelling Units
V' Floor Sq Ft & 2nd Floor Sq Ft _ _ 3'd Floor Sq Ft /►r_ _ _ _ . Unfiished Bsmt. Sq Ft
Finished Bsmt Sq Ft 1087 - # of Bedrooms # of Full. Baths —4— % Baths 0 '/2 Baths 0 # ofFireplaces
Air Conditioning: Yes ® Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative S. Prescriptive w/Air�Spealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # A/ MA - List appropriate option #s Ill
UTILITIES INFO:
Water Tap Size .. _ a Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or
Type of Heat: xGas ❑ Electric Electric Main Breaker Size (Residential only) /150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)
A o . t� a ♦l_ J •. �.
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
ElectricalMechanical sU�.l12 <��S Plumbing A 1
Framer o1,ng Iv Concrete � _�_ ____ _ Fireplace ry
Solar _ Other Other Wi Other .
1
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,4tate laws regulating building construction. -
Distribution: White — Office Yellow— Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE