HomeMy WebLinkAbout947 FOSSIL CREEK DR - APPLICATIONS - 12/30/2010City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760
www.fcgov corn/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 23A D � APPLICATION DATE b�Ir ,U
Job Site Address gy�oss�% Cre�� l7i: Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # -/ -7y - q98 - 2 & 0Z
Last name 7-1,0fdtsai✓i
First Name
S� a - t Middle
Street Address �7
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City F� 6/ � S State l O zip 8d.5 �D
CONTRACTOR INFO:: Company/ Name
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AMG.S: /-L(- Contractor Phone # q_2_�O— �31— 160 8
Lic Holder Name
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City of Fort Collins License # Supervisor Cert #
Mailing Address M257
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City )i4 [�f�it+� $ State eO, zip 94 �Z
LEGAL INFO: i
Subdivision/PUD �6r- pt opt PUP Filing # Lot #_. Block # Lot Sq Ft • az
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) .Z� 5.,• Fl�- Total Garage Sq Ft /V'+
Residential Sq Ft ffA�— Comm] Sq Ft IVA # of Stories Bldg Height41A # Dwelling Units AIA
15' Floor Sq Ft NA 2nd Floor Sq Ft / 43rd Floor Sq Ft 41A Unfiished Bsmt Sq Ft AIA
Finished Bsmt Sq Ft A4 # of Bedrooms _" # of Full Baths _,XI/-'/4 Baths 11A '/z Baths � # of Fireplaces AIA
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 # A14- List appropriate option #s
UTILITIES INFO:
Water Tap Size &A-- 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 hh
Value of Construction (including labor, material & profit) $ �6�46'wx
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Desc iption of Work: 14ij) � tan �9 �v,�0 ��� TD 7' `'� Leif "2 /fi��_ /K
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Contact Name & Phone # of JOBSITE SUPERVISOR: �• 3y�f " % '-1-0 '�'3f - /6 V 8
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
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 City of Fort Collins ordinances and state laws regulating building construction.
Applicant SignaturePrint Name Sc,.71r 10A4s6,, Phone
Distribution: White - Office Yellow - Applicant Pink WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE