HomeMy WebLinkAbout915 Pinnacle Pl - Applications/Addition or Alteration - 04/19/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
/ 5 n n C lC P/-BUILDING PERMIT APPLICATION
APPLICATION NUMBER ?)j I () R p APPLICATION DATE
Job Site Address } T 1. Zo LI, -1 y Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #( q�� � �- Q.S- t
LasF
t name (V ` First Name Middle
Street Address ` /14I - City Y l State CO Zip
CONTRACTOR INFO: Company Name S Contractor Phone # ( q l j��
Lic Holder Name Gilyl� ��G� City o Fort Collins License # Supervisor Cert #
Mailing Address IZ12 f/a (d rl (je City ` State �� Zip
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 '<#
3,d Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedroo of Full Baths 3/ Baths '/z Baths # of Fireplaces
Air Conditioning: Yes No En gy info: (Circle ap opriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Si lated Performance Alterna ive 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
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 orjp Less ❑ 200 Amp [-]Other
Value of Construction (including labor, material & profit) $
Description of Work:
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Contact Name & Phone # of JOBSITE SUPERVISOR: to ar (GS0yt
Subcontractor Info: /
Electrical /��j Mechanical L LA-1 'A
Plumbing v
Framer Roofing Concrete Fireplace
Solar Other Other Other
Applicant: I hereby acknowl ge hat I ve read th application and state that the above information is correct and agree to comply with all requirements
contained herein and Fo Colli s ordinances and state laws regulating building construction. G
Applicant Signatu Print Name yam ,( Phone "I 70 2(S —
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater ! ! ( I
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE