HomeMy WebLinkAbout3407 Stover St - Applications/Addition or Alteration - 03/04/2014 (4)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` O I APPLICATION DATE 3 l
Job Site Address 2 yQ 7 : -to uFA -511- Unit # ((; 712,
PROPERTY OWNER INFO: (All owner information Is required - It Is not optional) Phone # Z I 1 r-7 (o
Last name _ 1 L jC l First Name AX)D012 1.1�- �j Middle
Street Address - City F-7-�f State 42— Zip_g6�;
CONTRACTOR INFO: Company Name 25 0 J, Contractor Phone # O 7 / �3 Z y
Lic Holder Name A) - ' S O � City of Fort Collins License # /Supervisor Cert #
Mailing Address 45-2-5 6-/` oU nit4) y/iZ City r7 6 State 1, 6 Zip Q"f j 2.G
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft _
151 Floor Sq Ft
Finished Bsmt Sq Ft
Comm'I Sq
20d Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/. Baths '/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
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) $ 0
Description of Work: z9h Je' B&A
,1
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge that 1,rhav read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of F oil' rdinances state laws regulating building construction.
Applicant Signatu Print Name oV)WA
*' C19 "hone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE