HomeMy WebLinkAbout1312 Parkwood Dr - Applications/Addition or Alteration - 04/29/2010City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Col�ins 281 N College Ave Fort Collins CO 80522 0580 Phone 970 221 6760
www fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER !S I n-a �i / APPLICATION DATE Y I V
Job Site Address AA, Oe- %T—z.y&4 a Unit #
PROPERTY OWNER (INFO (All owner information is required - it is not optional) Phone #
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Last name d"'j &Z— First Name 1007NW Middle
/S/ZQ/I PA7eA- AC City �
Street Address yufH� State � Zip 4O'er 2 �
CONTRACTOR INFO Company Name /11l° ✓�Yr i�' f ^� ✓Contractor Phone # ��rz 97L
Lic Holder Name✓lei Wye QJ City of Fort Collins License # /1 10 Supervisor Cert #
Mailing Address S'v.¢4,f- Si � `f Lo Cdy u�,t�- State & Zip
Sz
LEGALINFO
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO Total Building Sq Ft ( of I d g b in
Total Garage Sq Ft
Residential Sq Ft Comm I Sq Ft # of Stories Bldg Height # Dwelling Units
Floor Sq Ft
Finished Bsmt Sq Ft
Air Condthoning Yes No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO
2 Floor Sq Ft
3rtl Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths / Baths / 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 0 Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including
�J labor
gmaterial & profit) $ 4//1 0�'
/fQ/
Description of Work M ff9i/'••, c %(n" f /'.�/ a'lswll 7 92—" `'F Z 194n e-,A.
Contact Name & Phone # of JOBSITE SUPERVISOR
Subcontractor Info
Electrical )JAM'A £(.rc- Mechanical
Framer
Solar
2717 ig?6
Roofing iA Q V^ WCCO IL4 Concrete
" cl
Other
Other
Plumbing -i 2i%0
Fireplace
Other
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 state laws regulating building construction
Applicant Signature Print Name Phone
Distribution White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE