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HomeMy WebLinkAbout930 W MOUNTAIN AVE - APPLICATIONS - 9/7/2005BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 www.fcgov.com/building City of Fort Collins BUILDING PERMIT APPLICATION APPLICATION NUMBER(0�5_05 I ;R rl APPLICATION DATE -7 " O �5 Job Site Address 9ZO vA5-r- r800mt* lit Ik-orUnit # PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # !!" S - 3© � Last Name WAG /,1 F_1 ,, n First Name FaV � 4l Mftf IE Middle Street Address �0 Vl r s-r N�oo TAtN Ai C City FA-, 6pL,L/jyS State CO Zip %;0 52 t CONTRACTOR INFO: Company Name �ItkVt. �C►-F2Bli� MES Contractor Phone # C 70 ors - f 321 Lic. Holder Name ?AyL SCFf-r_djriL City of Fort Collins License # T) I too Supervisor Cert #(A Mailing Address 52�q Cit40ur- State 6'0 Zip A©P 10 LEGAL INFO: Subdivision/PUD Filing # Lot # Block # Lot Sq CONSTRUCTION INFO: Total Building Sq Ft (not including basement) aS Z Total Garage Sq Ft N Residential Sq Ft S52. Comm'I Sq Ft # of Stories_ Bldg Height lJr��ON # Dwelling Units / O 1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft # of Bedrooms ® # of Full Baths C> % Baths n Y2 Baths ('�-,>— # of Fireplaces Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing O 3. ResCheck w/Blower Door City of Fort Collins Stock Plan # UTILITIES INFO: 4. E-Star w/Blower Door Water Tap Size Sewer Tap Size 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door r- List appropriate option #s 110 Metered: Yes or No Temp. Pedestal: Yes or No Type of Heat: Of Gas ❑ Electric Electric Main Breaker Size (Residential only): J5 150 Amp or Less 11200 Amp ❑ Other Value of Construction (including labor, material & profit) $ ` lCI Q C o Description of Work: I Ilk) 1=1 M 1C Ft✓R Contact Name & Phone # of JOBSITE SUPERVISOR: I, Szd" L, T70 566 Subcontractor Info. Electrical 41)0,A4 Mechanical p r-n %'wP" Plumbing Framer Suy'r %JF4-t L_ Roofing NCE.O Concrete Ft r _jL% aN Other 541_VCTvLAK_ N+C. GorHpMv Applicant: I hereby acknowledge that I have read his application and state that the above information is correct and agree to comply with all requirements contained herein and City of F s dinances and state laws regulating building construction. Applicant Signatur �— Print Nam t)�-�� Phone Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE