HomeMy WebLinkAbout1740 Concord Dr - Applications/Addition or Alteration - 02/23/2007City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER; / APPLICATION DATE c-
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Job Site Address I'140 P"1tva -> 'De- Unit #
PROPERTY OWNER INFO: (All owner information is required - it isrnot
�optional) Phone #
F• Last Name 440 First Name Middle •
Street Address 7 `� �2 City � State_
CONTRACTOR INFO: Company Name h�/k Contractor Phone #
Lic. Holder Name
Mailing
7in
City of Fort Collins License # Supervisor Cert #
City_
LEGALINFO:
Bl�bdivision/PUD Filing #_
CONSTRUCTION INFO: Total B ding Sq Ft (not including basement)
Residential Sq Ft
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO: N4,
Comm'I Sq
Sq Ft
# of F611 Baths
State
Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height #Dwelling Units
Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft �\
_ % Baths /z Baths # of Fireplaces v
E rgy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower oor 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s
Water Tap Size Sewer Tap Size Metered
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (R(
Value of Construction (including lab ro material & profit) $_
r /, _ ^ -e
Contact Name & Phone # of JOBSITE SUPERVISOR: �7GZL n
Subcontractor Info:
Electrical
Mechanical
or No Temp. Pedestal: Yes or No
): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
q'1v — 4'$2-6ll
Plumbing
a11K- e)
Framer Roofing 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 and state laws regulating building construction.
Applicant Signature (/L w Print Name 76>E1- //V E VAWO Phone
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE