HomeMy WebLinkAbout4820 S College Ave - Applications/Addition or Alteration - 04/28/2010City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins 281 N College Ave Fort Collins, CO 80522 0580 • Phone 970 221 6760
/ www fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER / (/ APPLICATION DATE
Job Site Address 41820 S Co%l*je IQ Unit #
PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone # -70
Last name/ / e-owA, e. b �- Ftrst-Name M0i0� rAtti (4/'`�✓I:k7 N4"eT% bokrnyaf �
Street Address '7�Za S, Col It AL it A� City �� f o�li rrS State Cy ZIP O�
CONTRACTOR INFO
� Company Name _/ ,� ✓` re j 6oeis-frt4 c'7't o^ Contractor Phone # 30 3 -(os a - /s7 7
nU Lic Holder Name a I P TG✓y e / City of Fort Collins License # —1 7 Supervisor Cert # 6.3
Mailing Address PO lq o W `l 7 3 City /AJ / t..td i State C t7 Zip 4FOS 4-1 L/
LEGALINFO
Subdivision/PUD Se fLl T ` P✓la �. Filing # Lot # Coo"
# Lot Sq Ft S7 eeG -
CONSTRUCTION INFO Total Budding Sq Ft (not including basement) �795 Total Garage Sq Ft
Residential Sq Ft Comm I Sq Ft # of Stories Bldg Height # Dwelling Units
1 ' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning Q No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO
2 d Floor Sq Ft
# of Bedrooms
3 d Floor Sq Ft
# of Full Baths 3/. Baths
Energy info ( Circle appropnate choice ) 1 ComCheck
Unftished Bsmt Sq Ft
'/2 Baths # of Fireplaces
2 ResCheck w/Air Sealing
4 Simulated Performance Alternative 5 Prescriptive w/Air Sealing
List appropriate option #s.
6 Prescriptive w/ Blower Doo/
V�
Water Tap Size Sewer Tap Size Metered Yes or No Temp Pedestal Yes or
Type of Heat N Gas ❑ Electrc Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other\
,,����i �� //�� ,{.,.�--,� GU`L�K��G�k-n�
Value of Construction (including labor material & profit) $ 4kn4 t- �Tlj Vy v
Description of Work 4 - : e Lt—, Qc
Contact Name & Phone # of JOBSITE SUPERVISOR S(t 6- 1776
Subcontractor Info
Electrical OYe4 loot- FIGCAV- L Mechanical Fl"X C0-60w►
Framer Roofing Concrete
Solar
Other
Other
Plumbing gko/k his �,u"►1b,n4
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 Ilins ordinances and state laws regulating building construction
Applicant Signature a-t�` not Name %� le"� 7 Phone .Z 2-L— 9 SO
Distribution White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE