HomeMy WebLinkAbout631 MEADOW RUN DR - APPLICATIONS - 10/14/2011 (2)City of COMMUNITY DEVELOPMENT & NEIGHBORI OOD' SERVICES
F6rt'CoRmS 281 N. College Ave. a -Fort Collins, CO 80522.0580 a Phone:.970-221=6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
'I APPLICATION NUMBER 1 ��C� � APPLICATION DATE'. I t4'l lI ;I
Job Site Address iy 51 '-1i W_Lwn `j)r' Unit #
PROPERTY OWNER INFO: (All ownerinformation is required!- it I n optional) Phone # 9 -jo— 3-7/ - 6-7
Last First Name Irs A
Middle �'�!•
Street Address cs,N r City!�i L}�S Statz QS _
CONTRACTOR. INFO: Company -Name VA: Contractor Phone,#_
'Lic Holder Name City of Fort Collins License #' Supervisor,Cert.#,
Mailing Address City State Zip
LEGAL 1N FO:
Subdivision/PUD Filing # Lot # Block# Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft(not including basement) Total Garage Sq Ft _
Residential Sq !Ft Comm'l Sq Ft # of Stories Bldg, Height #,Dwelling Units
16' Floor Sq Ft
2nd' Floor Sq, Ft
31d' Floor Sq Ft
�Unfiished Bsmt Sq, Ft
Finished Bsmt Sq Ft la S' • # of Bedrooms # of FuK Baths % Baths '/2 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/iBlower Door
City.of Fort Collins Stock Plan # List appropriate option #s
nillsrfl-=611.► .
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' & profit), $ 199 J ly. W
Description of
Contact Name & Phone#.of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Mechanical
Roofing Concrete
Other
Other
Plumbing
Fireplace _
Other
Applicant: [hereby acknowI have. this. application and!state that,the:above'information is correct.and,agree to comply with, alivequirements
contained herein and City Fort Collin ordin n state I s regulating, building construction. j /
Applicant 'Signat e�" ' Print'Nam�g�'Lt_�lL Phoned
Distribution: White —Office Yellow. —Applicant (Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE