HomeMy WebLinkAbout604 SMITH ST - APPLICATIONS - 7/28/2010BUILDING PERMITS 8L INSPECTIONS DIVISION
PO Box 580 FortCollins CO 80522-0580 Phone 2216760
t, ;0�k www fcgov com/butlding
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER I) t DO APPLICATION DATE A `,0
Job Site Address go 6 m i� 5dY'-E—!9l Unit #
PROPERTY OWNER INFO ((All owfner information Is required - it is not optional) yPhone # ^��—
Last Name �/�'i`T J b M First
Naamme�r.� � C 1� 1 Middle C)
Street Address b d 4 J � / �� S l l�C: J City �G„'%T Call )A q State C odpJrZ
CONTRACTOR INFO Company Name Y�E -� Contractor Phone # OT
Lie Holder Name
r
Mailing Address
LEGALINFO
Subdivision/PUD
City of Fort Collins License # Supervisor Cert #
City_
4�i0 lWvA Cod (Bi�, t-)�
CONSTRUCTION INFO Total Budding Sq Ft (
State Zi
Filing # Lot # Block #_[J,�_ Lot Sq Ft rJ6a
1 d g b m t) "1 Total Garage Sq Ft% moo(, L' �5
Residential Sq Ft 16 Comm I Sq Ft NIA # of Stones Bldg Height Q I ^ # Dwelling Units
1 Floor Sq Ft61 C1 ::7- 2 d Floor Sq Ft N$ Unfinished Bsmt Sq Ft 1 463 Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths �_ / Baths / Baths Q # of Fireplaces G'
Air Conditioning Yes No Energy info (Circle appropnate choice) 1 ComCheck 2 ResCheck w/Air Sealing
3 ResCheck w/Blower Door 4 E Star w/Blower Door 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 Sewer Tap Size `-) I Metered Yes r No Temp Pedestal Yes or No
Type of Heat�Gas ❑ Electric Electric Main Breaker Size (Residential only) x150 Amp or Less 11200 Amp ❑ Other
i M t A -.1-, � _
VA AM till 3.1111M W11111
i
. '. or
Framer
Roofing
Concrete
Other
Applicant I hereby acknowled that I have read t is application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Col11 s ordinanc sta a laws regulating building,, construction /� ,
Applicant Signature Print Name VI �i�-t T SC6: c)VPhonete ?7fC0/L/�/ D /�7
Di abut on White — Office Yellow — Applicant Pink — WWW/Stormwater (,
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE