HomeMy WebLinkAbout3051 Sage Creek Rd - Applications/Addition or Alteration - 07/26/2013COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER I �Oy I' APPLICATION DATE Z (P. Z D I "'
Job Site Address �1 �� �iA 6E �7 Wl-f pUnit # �y I -
PROPERTY OWNER (INFO: (All owner information is required — it is not optional) Phone #
Last name T` llD V E F First Name `! -VL E Middle l
Street Address �0 ti e e ' �} City State C D zip y2�
CONTRACTOR INFO: Compan Name IVIA, Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cart #
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD Tr L e Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
ls' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
*,7' # of Bedrooms
3'd Floor Sq Ft _
# of Full Baths I '/. Baths
Unfiished Bsmt Sq Ft /
/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 #s
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) $ Description of Work: */;i �At tt AA�r� -h
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: t '
Electrical Mechanical Plumbing
Framer Roofing Concrete Fireplace
Solar Other 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 Colli s o dinances and state laws regulating building construction.
Applicant Signature Print Name rZratR 61+ Phone 7�Zlo%C3
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE