HomeMy WebLinkAbout631 MEADOW RUN DR - APPLICATIONS - 5/27/2010City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Co�lm 281 N College Ave Fort Collins CO 80522 0580 Phone 970 221 6760
www fcgov corn/budding
BUILDING PERMIT APPLICATION
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APPLICATION NUMBER / )1 00 ��y.� APPLICATION DATE ��1 /O
Job Site
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Unit # N 1A-
PROPERTY OWNER INFO (All owner information is required- it is not optional) Phone # (; l0 ` ,17 0-710S
Last name 1`il'Ly.&m-c e First Name t`�VIC.T�z-S/+ Middle A
Street Address (pal fAf-c IOw v1J dbr C I t I"�1 C01I %NS State(:0 Zip?6$52�;-
CONTRACTOR INFO Company Name xk /) C_ Contractor Phone #
Lic Holder Name
City of Fort Collins License # Supervisor Cert #.
Mailing Address City State Zip
LEGAL INFO
Subdivision/PUD i" IML.MOIVIJ Filing # �5 ���++ Lot # Block # Lot Sq Ft 91 0010
CONSTRUCTION INFO Total Building Sq Ft ( t I d g b eme t) Total Garage Sq Ft
Residential Sq Ft Comm I Sq
Floor Sq Ft
Finished Bsmt Sq Ft
2 d Floor Sq Ft
# of Stones Bldg Height # Dwelling Units
3 Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths / Baths / 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
List appropriate option #s
Water Tap Size /7 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) $
Description of Work
Contact Name & Phone # of JOBSITE SUPERVISOR
Subcontractor Info
Electrical
Framer Roofing
Solar Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant I hereby acknowl ge tha I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City Fort Col ord a ce nd state ws regulating building construction 1 j
Applicant Signat Print Name �CS �lLy-4/hU✓ Phone 31>- 0 (03
Distribution White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE