HomeMy WebLinkAbout5740 S College Ave - Applications/Addition or Alteration - 05/16/2013City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort+t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
/� \\ BUILDING PERMIT APPLICATION
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APPLICATION NUMBER /� (/ r d f APPLICATION DATE J —16
Job Site Address
Unit # C
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #_
Last name First Name au Middle `1
Street Addres amainto city %'r Ar C/>1J/fj !T State(7,1!�? Zig6Q
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
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft
1 st Floor Sq Ft
Finished Bsmt Sq Ft
Comm'I Sq
2nd Floor Sq Ft
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/z 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:
Water Tap Size Sewer Tap Size
List appropriate option
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) $
DeV4iption of Work:.?�_�l%v I—ead 919ff p/ 1iQ
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Into:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowled a 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 Collins ordin ces q d state laws regulating building construction.
Applicant Signature Print Name r Phone 7
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE