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HomeMy WebLinkAbout1712 Ridgewood Rd - Applications/Addition or Alteration - 08/22/2012COMMUNITY 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 M5 61 APPLICATION DATE Job Site Address / 712- -Z) 4-- Unit #. PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Al Last name i `�Lk� First Name (A4A--f Middle Street Address / 71 2 �z(7,� cwn City C-- Stated Zip i �D CONTRACTOR INFO: Company NContractor Phone # 21'�� - -53`2` C7) Lic Holder Name /LsA-N // ii�S City of Fort Collins License # 4 � Supervisor Certt # � `7 Mailing Address l© �S Al t1--y 2E3 7lf� _*�3 City � State CCD Zip LEGAL INFO: Subdivision/PUD Filing # Lot # Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft Residential Sq Ft 1s' Floor Sq Ft Finished Bsmt Sq Ft Comm'I Sq 2"d Floor Sq Ft # of Stories Bldg Height # Dwelling Units 3`d Floor Sq Ft Unfiished Bsmt Sq Ft # 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: List appropriate option 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 ❑ 200 Amp ❑ Other Value of Construction (including labor, material & profit) $ dG� Descripn of Work: T -40-r---n , , L_^ Contact Name & Phone # of JOBSITE SUPERVISOR: ,A,1� Subcontractor Info: Electrical Framer Solar Applicant: I he y acknowli contained herein d City of Applicant Sigha ur� Mechanical Plumbing Y Roofing Concrete Fireplace Other Other Other h have rea this application and state that the above information is correct and agree to comply with all requirements s ordin ces and state laws regulating building construction. Print Name_�'Phone -Office Yellow- Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE