HomeMy WebLinkAbout931 FOSSIL CREEK PKWY - APPLICATIONS - 1/10/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER / ,_I /.� APPLICATION DATE ' / (J /
Job Site Address 9 3 (fieei: pxG lAr Unit # C
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # �O %
Last name 1�0 I �First Name �"' �% Middle_ -
Street Address vS S� C�� Y'� City ( State W zip
CONTRACTOR INFO: Company Name e °� G`` "" �� Contractor Phone # q % o a- % 0
I it I-inlri,-r Nam,- 1 O f e Y. L eiil oCb City of Fort Collins License # D-.S' 9 3 Sunervisor Cert# W 0 3 — D)
Mailing Address �� E`er 141 1( VG1 City 1 State 6:131 Zip To
LEGAL INFO:.
Subdivision/PUD TT'v,"' 10 S �n i I J Filing # Lot # Block # Lot Sq_ Ft l l / C�' �
CONSTRUCTION INFO: Total Building Sq. Ft (not including basement)/�' y?s Total Garage Sq. Ft `� 3 Y
Residential Sq Ft �7 > Comm'I Sq. Ft # of Stories Bldg Height �r # Dwelling Units
15l Floor Sq Ft ) S 00 2"tl Floor Sq, Ft s % S 31" Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft �(� U # of Bedrooms _ # of Full Baths 3/4 Baths ___L_'/2- Baths # of Fireplaces
Air Conditioning: l e 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 #
["l11SOL*31`►1r�H
List appropriate option #s
Water Tap Size Sewer Tap Size Metered: Yes No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only)
Value of Construction (including labor, material & profit) $ 14
Descri ti9n of Work: AA flour �t-c( �[, -rf0 ! A I l/
a o�dl I T+�'+, Dea_ d- u X
Contact Name & Phone # of JOBSITE SUPERVISOR: I O!2�j �_e4
Temp. Pedestal Yes No
150 Amp or Less 200 Amp Other
v ✓ iafrr
Mol
Subcontraclor Info: nn,� /
Electricali V �C qe-C Mechanical �rfi (✓o l� j � Plumbing
Framer e/1 °G _Roofing e4cr" Concrete �!I c7i✓ Fireplace
Solar N Z,41Other Other Other.
/1N /A
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
tCCollins ordinances and state laws regulating building construction.
Applicant Signature ` 6 (Jr ` l �--- Print Name Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stonnwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE