HomeMy WebLinkAbout352 Albion Way - Applications/Garage - 04/06/2010COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760
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BUILDING PERMIT APPLICATION 413 , J
APPLICATION NUMBER � t M I u �5 APPLICATION DATE I �I rJ 10
Job Site Address es f} /O i ova WAI Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name S54faoh First `Name �(.1 cc [nf_ Middle
Street Address 3�0'2 > 11Jr Gn W/4�/ City F0_ State_<a)_Zip j
CONTRACTOR INFO: Company Name ��/�' Contractor Phone #
Lic Holder Name
Mailing
City of Fort Collins License #.
Supervisor Cert #
State Zip
LEGAL INFO:
Subdivision/PUD S o N4-k £ Filing #_ Lot #__�/_ Block # Lot Sq Ft02 � g3
pzV' / �j
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) n ( Total Garage Sq Ft O �Pq
Residential Sq Ft �) W Comm'I Sq Ft — # of Stories_ Bldg Height / t" ' # Dwelling Units
1s' Floor Sq Ft V 2-d Floor Sq Ft 3'd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft - # of Bedrooms — # of Full Baths 3/a Baths "— '/2 Baths — # of Fireplaces -^
Air Conditioning: Yes <0 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:
Water Tap Size Sewer Tap Size
List appropriate option #s
Metered: Yes or No Temp. Pedestal Yes or
Type of Heat:-�� ' Ef is Electric Main Breaker Size (Residential only) X,5�0 Amp or Less
Value of Construction (including labor, material & profit) Z J't -91 // l/
Description of Work: �� ����>✓d C f}%2R4f
❑ 200 Amp []Other
Contact Name & Phone # of JOBSITE SUPERVISOR: ? �h �_ 7y�o� {f - ZZ�P _ �� 3y- Q.R
Subcontractor Info:
e-4!� -33/7
Electrical Mechanical Plumbing
Framer
Solar
Roofing
Other
Concrete
Other
Fireplace
Other
Applicant: I hereby acknowledge that I have read this ap i ation and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fo ollins ordinances ands to laws regulating building construction. --// /
Applicant Signature Print Name �U S < h F S7 eok Phone 49 - 5/83 7
u
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE