HomeMy WebLinkAbout3407 Stover St - Applications/Addition or Alteration - 03/04/2014 (2)City 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 l Oil / 1 APPLICATION DATE ✓ r 41/iff
Job Site Address � yD 2 -5 4-pvr72 Unit # r-5 2/ /
PROPERTY OWNER INFO:
(All owner information Is required - it is not optional) Phone # I�
2 2 /
Last name 4
Z441
rvS First Name R,4r," T6-,V Middle
Street Address
City /✓ % C
Statef�Zip !P
CONTRACTOR INFO:
Company Name Contractor Phone #
!/a$
3 C7 r/ 5 3 7
Lic Holder Name
��b�
f.4 5 O W City of Fort Collins License #
Supervisor Cart #
Mailing Address
(c� ?2
��4
t 9k16W V City ZEE E State
0 a Zip 005Z fo
LEGAL INFO:
Subdivision/PUD 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 _
1s' Floor Sq Ft
2nd Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 1/4 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:
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
Value of Construction (including labor, material & profit) $
Description of Work: y:N S/ g s 0
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge th t Vhave read this application and state that the above information is correct and agree to comply with all requirements
contained herein an f Fort C I' is ordinances a state laws regulating building construction. q (�
Applicant Signatur Print Name V N%D�Sy� Phone & / 5-�� /
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE