Loading...
HomeMy WebLinkAbout938 W MOUNTAIN AVE - APPLICATIONS - 9/19/2005BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 www.fcgoV.com/building of Fort Collins BUILDING PERMIT APPLICATION APPLICATION \ APPLICATION DATE Job Site Address q 38 W Unit # PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Last Name `�a Q O—CA First Name -YlA k' t Middle Street Address LJ VkQuvA-�V^• City - deli S State=Zip L CONTRACTOR INFO: Company Name /t-,f-rS Contractor Phone # Lic. Holder Name Yam-('] •.c 1 _ SL { _ City of Fort Collins License #�4� Supervisor Cert # Mailing Address City- ���kS State_ Zip �©S 2 LEGAL INFO: Subdivision/PUD Filing # Lot # Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not including basement) / Total Garage Sq Residential Sq Ft Comm'l Sq Ft # of Stories ��_ Bldg Height # Dwelling Units 1st Floor Sq Ft (� 00 2nd Floor Sq Ft Unfinished Bsmt Sq Ft C.) Finished Bsmt Sq Ft # of Bedrooms 0 # of Full Baths C`� % Baths O '/2 Baths # of Fireplaces d �4 Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door V E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door City of Fort Collins Stock Plan # List appropriate option #s M UTILITIES INFO: Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No Type of Heat: ❑ Gas ElElectric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less L9'200 Amp ❑Other Value of Construction (including labor, material &profit) $ � Description of Work:_ ch►,� �r- c0,.._ d �e �- t'r S ' n �" Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: ElectricalG..v,,S Mechanical mm hanical i riuog i/p-9, a Framer D_Aw; .C' %Roofing � C s=W , Concrete � � 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 a state laws regulating building construction. Applicant Signature Print NamPhone H7 2. — t9oo > . Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE