HomeMy WebLinkAbout820 Merganser Dr - Applications/Addition or Alteration - 07/26/2013City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER I J (2:)10 I APPLICATION DATE '/ bto 13
Job Site Address !2.20 M Prct Aru Sve Unit #,Z/Ca;tle)r? A 10'7
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #.
Last name) r C-4h p I Ce - First Name_
Street Address ' a m to it G InkfV Se
CONTRACTOR INFO: Company Name
Middle
City State_C 0_Zip.
Contractor Phone
Lic Holder Name 'FI&Weli' ¢' c h, City of Fort Collins License # Supervisor Cert#32Z6 -CZ
Mailing Address %"4 4t City (?L,1, l wk 1&)_ State CO Zip s_gO""I
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft
1'Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
Filing # Lot # Block # Lot Sq
Total Garage Sq Ft
Comm'I Sq Ft # of Stories_,:),_Bldg Height_ # Dwelling Units 3
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
3`d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms r` # of Full Baths_ 3/. Baths Yz Baths # of Fireplaces
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative S. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
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
i
Value of Construction (including labor, material & profit) $
t
Description of Work: t-rum 2 OV0
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:: a�
Electrical -R'l.' f11 �j 1We_ Mechanical AA &?re� �>O—VL a-- Plumbing ff�yc— i9(o,4A .1
Framer �/�tc HG �{1/I Roofing �leJcAe Ct-h^ 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 Collins ordinances and state laws regulating building construction.
7'LO c� G/�
Applicant Signature � C Print Name ra'aJ dGH�/�jZ— Phonedg7- c5lb
Distribution: White —Office Yellow —Applicant Pink —WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE