HomeMy WebLinkAbout2103 Joseph Allen Dr 9 - Applications/New Commercial - 08/10/2007BUILDING 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 V , h APPLICATION DATE ' 'Y 0'�
Job Site Address Unit # ll I`
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # -a) 11 "�S)Q
Last Names3t�'-'�d Y First Name 19 (a, Middle
Street Address City State Zip_
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cert #_
Mailing Address City State Zip_
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft_
CONSTRUCTION INFO: Total Building Sq Ft (not including baseme tt) CT�o� I Ca> ge Sq Ft
Residential Sq Ft Comm]Sq FtQ # ofitories Bldg Height I #Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# of Bedrooms # of Full Baths 3/4 Baths Yz 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. 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
UTILITIESINFO: qh
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
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Value of Construction (including labor, material & profit) $ 040 . 00 v
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
❑ 200 Amp ❑ 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 Collins ordinances and ate laws regulating building construction. _
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Applicant Signat� Print Name [ Phone ! [
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE