HomeMy WebLinkAbout1900 Turnberry Rd - Applications/Shed - 10/05/2012City of II COMMUNITY 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 /� 1�7 6 % APPLICATION GATE 10 .S — /
Job Site Address 1 9 d O 7"''J t" b -�-- r -/ Rd Unit #
PROPERTY OWNER INFO: (All owner information is required - it is /not optional Phone # / 7 0 - Z - � C 6
Last name %31— 0 w � First Name V ��� � 1" �� Middle
Street Address / 9 00 -7 ''� rJ -��' �('' 1 City ���' G State G 0 Zip g OS
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
Mailing
City of Fort Collins License #.
City
LEGAL INFO:
Subdivision/PUD �O ✓ b ,v5 /� t b 1� Filing # Lot # 3
Supervisor Cert #,
State
Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)e!i �/ Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height_ # Dwelling Units
161 Floor Sq Ft
2nd Floor Sq Ft
31 Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms ' # of Full Baths 3/4 Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing M
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:
Water Tap Size Sewer Tap Size
List appropriate option #s
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) $ 15
I %l�
Description of Work: Pi> /.- 13 a v- h S4V 1 � ,L oCn -11 v, G, S4
Ui t- - - F / o v'r- — A/ o y /..e_c�-f- - /V o (. Jz1----e-Y
Contact Name & Phone # of JOBSITE SUPERVISOR: S -e—
Subcontractor Info:
Electrical
Framer Roofing
Solar Other
Mechanical
Concrete
Other
Plumbing
Fireplace
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 Fo Collin ances and state laws regulating building onstruction.
Applicant Signatur Print Name
97�-zzZ-� 6 6 9
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE