HomeMy WebLinkAbout2161 S College Ave - Applications/Electrical - 10/02/2014Fort Collins
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APPLICATION NUMBE
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION 0,
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APPLICATION DATE ��TV V ��L Z.1 Z 0 1 J
Job Site Address 24"--s s , Lo (,LE-6E Ave . Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 170 'ZZ Z 3 5-7 10
Last name C.IT%A F T Co C,C.IN S First Name MW-K LAV-etJ Middle o
Street Address Z� 1 Cof�zGr City �T 60CX-WN • State (_O Zip OOSZ
CONTRACTOR INFO: Company Name CorJc2E7E C9102Eb511 1 pC. Contractor Phone #
Lic Holder Name
City of Fort Collins License # Supervisor Cart #
Mailing Address Z0Z7 W. CoLFAx. City State l`O Zip sOzOy
LEGAL INFO:
Subdivision/PUD I" Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 8 t9 o o S 1 Total Garage Sq Ft 0
I O
Residential Sq Ft CS Comm] Sq Ft Q # of Stories Z Bldg Height�#.Dwelling Units
15' Floor Sq Ft - d 2nd Floor Sq Ft 3'd Floor Sq Ft d Unfiished Bsmt Sq Ft 0
Finished Bsmt Sq Ft O. # of Bedrooms 0 # of Full Baths Q % Baths Q Y2 Baths 0 # of Fireplaces
Air Conditioning: Yes (a 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: hh
Water Tap Size Sewer Tap Size h-3 r1
Type of Heat: ❑ Gas ❑ Electric Electric Main Break
Value of Construction (including labor, material & profit) $
List appropriate option #s
Metered: Yes or No Tern es or No
Size (Re❑ential only) 150 Amp or Less X200 Amp El Other
Contact Name & Phone # of JOBSITE SUPERVISOR: Jr-O oSo 3 — q7G, g6o6
Subcontractor Info:
Electrical 5Tu"150tJ ,EL-6t1 -I C Mechanical (A n Plumbing tj IA
Framer N�1�t Roofing 7�� Concrete' Q>-/ e2kME Fireplace P
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Solar 1_ l fc Other _ [�jlC� (� `gam Other Other
Applicant: 1 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 olli s ordinances and state laws regulating building construction. Applicant Signature—At.1.- Print Name (AAR"K LA"rj —Phone?
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Distribution: White — Office Yellow — Applicant Pink — WWW/Stor6ater
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