HomeMy WebLinkAbout6802 NIMITZ DR - APPLICATIONS - 11/4/2014COMMUNITY 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
APPLICATION NUMBER 07t l'I I 1 APPLICATION DATE I I 1 `1.41 11 :
Job Site Address
1 WL
Unit # i D l
PROPERTY O R INFO: (All owner information is required - ittiis--not -optional) Phone # 1 T d -7(, :3 llJ
Last name 23�ry5 ( �{ First Name -d 0 r.l�� Middle
Street Address L t °M l `z , r- City LA 11 t t/lS State eb zip _
CONTRACTOR INFO: Compa y Nam � \ ��0.�` �SContractor Phone # 7� l� -ZgZ- ]S(0a d
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Lic Holder Name r-(S(� - %� a� ��' j City of Fort Collins License # i Z-`�� Supervisor Cert(#�1 5 �/
Mailing Address � t � 1.� � `� City�� 0) (t K5 State EO zip ZX (o
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 Comm1 Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
2nd Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft -590 # of Bedrooms # of Full 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/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Water Tap Size Sewer Tap Size
List appropriate option
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 (inc labor, R material &profit)
-7S_-7 +.
w/C� Sl� . 1It/iv
Contact Name & Phone # of JOBSITE SUPERVISOR: ,��® OJ_�
Subcontractor Info:
Electrical Mechanical (r-L Plumbing) t 6r(,
Framer Roofing Concrete Fireplace
Solar
Other
Other
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 Collin r ' ces and state laws regulating building construction.. jj - �L�?
Applicant Signature Print Nam
4 __Q0_A_4 t T_ Phone 2-`3L o
iribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE