HomeMy WebLinkAbout6802 NIMITZ DR - APPLICATIONS - 9/23/2011COMMUNITY 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 A
APPLICATION NUMBER I I Q-7 C :)C' APPLICATION DATE
Job Site Address 6W2- IJ►MIT1 OyLiwE
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone
Last name VVAS L 151 i First Name ►AnA� ul ►J
Street Address b8t2 1�iM'tT_Z 0V2'%qE DIOt City
Unit # N0I
e0-Tc01.t,+ N S
Middle
CONTRACTOR INFO: Company Name -uW'oV;,:� P>^45e:7MIZ' IQK Contractor Phone #_
Lic Holder Name n l "ILOQ- City of Fort Collins License #.
State C'O Zip 31]5�o
.1—IL"
Supervisor Cert #
Mailing Address 6-S\4 KAAMA LAO-VT 6" PVQ AC City V.I 10 05CV-- State W Zip
LEGAL INFO:
Subdivision/PUD Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s` Floor Sq Ft
2M Floor Sq Ft
31d Floor Sq Ft
Finished Bsmt Sq Ft 4QW # of Bedrooms I # of Full Baths
Air Conditioning: Yes No Energy info: ( Circle appropriate choice )
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Unfiished Bsmt Sq Ft
'/< Baths I % Baths # of Fireplaces
1. ComCheck 2. ResCheck w/Air Sealing
6. Prescriptive w/ Blower Door��
9Q
J
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 8 profit) $ -" , 0" 'too
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing
List appropriate option
Description of Work: F1 t l %sw toyi to (e.- pon1M 3 14 m-yitt bapt2 mA
Contact Name 8 Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical 61LAX-,- WtTZ1aG- Mechanical
Framer \r, Roofing
Solar
Other
Concrete
Other
Plumbing V\AOnA►ifvi�)
Fireplace
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 Cit f Fort Ili rdinances and state laws regulating building construction.
Applicant Signature I Print Name L —W-ocyL Phone ZA-114lq
D' tribution: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE