HomeMy WebLinkAbout913 VANDERBILT CT - APPLICATIONS - 7/18/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER , I G_3�'� APPLICATION DATE
Job Site Address �/imp�►Lj— C-1- Unit #.
PROPERTY' OWNER INFO: (All owner information is required - it is not optional) Phone # (q%T� -58Yq
L Last name 62� First Name H Middle e
Street Address I %� � /aiL� g [J t- C-r City Z,g2t- C OLL NtJe, State ( Zip 005?'
CONTRACTOR INFO: Company Name A' /26 Contractor Phone #
Lic Holder Name T City of Fort Collins License # Supervisor Cert #
Mailing Address
LEGAL INFO:
Subdivision/PUD
City_
Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm] Sq Ft # of Stories,
1st Floor Sq Ft
2nd Floor Sq Ft
3rd Floor Sq Ft
State Zip
Block # Lot Sq Ft
Total Garage Sq Ft
Bldg Height # Dwelling Units
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO: �J/A--
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 Size (Resid tial only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ -C') c;> 3
Description of Work: IR1 �y�►,( c7D i �L l7 ►
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: m0r-
Electrical
Framer
Solar
Roofing
I:a 17M
Mechanical
Plumbing
Concrete Fireplace
Other
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 ordin ees2ml-st to laws regulating building construction.
Applicant Signature Print Name �-�C��/ C_��i5 Phone 170 qaS/y
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THUS APPdOCATOOM EXPORES 180 DAYS FROP& APPdOCA798M DATE