HomeMy WebLinkAbout1917 Pawnee Dr - Applications/Patio Cover Or Sun Shade - 10/28/2013City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
-' rt Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fc!)ov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER �3b S(��i I APPLICATION DATE ID- PV — 13
0
Job Site A
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone
Unit #
Last name �2 First Name ql� 1 L' Middle
Street Address k C1 P/W IJet 2 . City rr State zip
CONTRACTOR INFO: Company Name QeUNO�w4�]uY[c Contractor Phone #(54c)) su' -Z %to 3
Lic Holder Name W1VJ- - 1Ztf.4, City of Fort Collins License #_ O'Z 0-1 Supervisor Cert # u
Mailing Address Lem\- 14> City AtfC6— State Zip e4rdz
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) %S0 Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
151 Floor Sq Ft 2o1 Floor Sq Ft 3m 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: YerNo� Energy info: ( Circle appropriate choice) 1. ComCheck ❑ 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing11 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes F—]Nol:l Temp. Pedestal Yes❑ No
Type of Heat: nGas Electric Electric Main Breaker Size (Residential only) F-1150 Amp or Less ❑ 200 Amp DOther
Value of Construction (including labor, material & profit) $ --Zr 6g: Q c-) r
Description of Work: N17Vl,j-rjM0%3 7(L t0e—(4011 .+A /S) S�
Contact Name & Phone # of JOSSITE SUPERVISOR:
suocontractor into:
Electrical �� Mechanical
Framer / Roofing �`-
Solar Other
Concrete I,
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge that I have read t ation and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins ord ces and star laws regulating building construction. �y �r�66 II
Applicant Signature�_� Print Name 1Mle 4. Phone �7U 'StYD Z t0 3
Distribution: White - Office Yellow - Applicant Pink - VWMNStormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE