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HomeMy WebLinkAbout516 Laporte Ave - Applications/Addition or Alteration - 07/06/2010City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES Fort+t Collins 281 N College Ave Fort Collins, CO 80522 0580 • Phone 970 221 6760 / � www fcgov corn/budding BUILDING PERMIT APPLICATION APPLICATION NUMBER APPLICATION DATE c Job Site Address !p L AR&4P_-r_- A-,�t Unit # 0 PROPERTY OWNER INFO (All owner information is required - i not optional) Phone # 6Z(// _50 C-1 Last name C� =�To� First Name Middle r' /� Street Address r2O City C— Stgtt <21 Zip��F5 CONTRACTOR INFO Company Name >_— �'��� w Contractor Phone # Lic Holder Name "�_,NJ �ti _� City of Fort Collins License # Supervisor Cert #_� Mailing Address / d z•; AD disu_ 2B7_;1t�Z City State C© Zip LEGAL INFO Subdivision/PUD Filing # Lot # Block # Lot Sq Ft CONSTRUCTION INFO Total Budding Sq Ft (not including basement) Total Garage Sq Ft Residential Sq Ft Comm I Sq 1 ' Floor Sq Ft Finished Bsmt Sq Ft 2 d Floor Sq Ft # of Stories Bldg Height # Dwelling Units 3 d Floor Sq Ft # of Bedrooms # of Full Baths '/. Baths Unfiished Bsmt Sq Ft _ '/2 Baths # of Fireplaces Air Conditioning Yes No 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 No Type of Heat ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other Value of Construction (including labor material & profit) $ C-1) f nofWork /­'-' '�%�i� 416 Contact Name & Phone # of JOBSITE SUPERVISOR 'Z 1 a r 3 �(3D Subcontractor Info Electrical Mechanical Framer Roofing Concrete. Solar Other Other Plumbing Fireplace Other Applicant I hereby acknowledge that I hav read this apple tion and state that the above information is c nd agree to comply contained herein and City o ins nces and sta� laws regulating building construction �y',�� Applicant Signature t Name none Distribution White -Office Yellow -Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE with all requirements 2i.2.-3'�q0