HomeMy WebLinkAbout3000 Stanford Rd - Applications/Shed - 03/11/2010City of
I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
�t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER �o�� APPLICATION DATE
Job Site Address �0�0 S/J'�ie�''2�, �e��.�S Unit #
970- >=x6)-qq7/
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # !q -70 — Ct 3 f — SSO 3
Last name C 7 Gt ��a\ First Name (ot-I Az' O 2 Middle -::Td 5-
Street Address -?coo�i'a���e �Ol • City �d /L �O ��/ �S State 6" 0 Zip SdS�
CONTRACTOR INFO: Company Name
Contractor Phone
Lic Holder Name City of Fort Collins License # Supervisor Cart #
Mailing Address City State Zip_
LEGAL INFO: //� _� �1
Subdivision/PUD %/�AfC4 MdO/2 �SAA*ng # Lot # 41 Block # Lot Sq Ft / 60E 60
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 13 (P Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
1s' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2"d Floor Sq Ft
r
# of Stories I Bldg Height 10 # Dwelling Units
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/4 Baths '/2 Baths # of Fireplaces
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
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 ❑ Othei
Value of Construction (including labor, material & profit) $'?-z;)CJ - 0-0 /_ G , /
Descriotion of Work: 5�d�aoi P / (/ T'z ��/ �^�'� / ti �a d /� Y
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer Roofing
Solar Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
i
Applicant: I 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 Collins ordinances and stat laws regulating building construction.
Applicant SignatyrlPrint Name (7/2 PGJ (/7GrDltAlQ Phone 9�y "')') 9 917
CCC y 70
istribution: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE