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HomeMy WebLinkAbout620 Maple St - Applications/Addition or Alteration - 08/02/2010COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES Fort Collins APPLICATION 281 N College Ave Fort Collins CO 80522 0580 Phone 970 221 6760 www fcgov com/building BUILDING PERMIT APPLICATION Site Address W 7 © Ot h," e S APPLICATION DATE 7_c;� `fV 4 Unit #. PROPERTY OWNER INFO (All owner information is required - it ,s not optional) Phone # rt^7J .ast name %IV(�/'Iy^��� First Name �1� t-a/ Middle �A Street Address C1 a %OIL"@ Il; City /1 l(� t State —CO' -Zip JCl7 q' CONTRACTOR INFO Company Name � Contractor Phone # 4 r J f / S 3 /to Lic Holder Name Mailing LEGAL INFO City of Fort Collins License #. City. Subdivision/PUD E 3S Ft Lc(s y5 c y�, Filmg # CONSTRUCTION INFO Total Building Sq Ft t t I d g b m Residential Sq Ft .1-7L- Comm I Sq Ft_ 1 Floor Sq Ft a 2Z 2 Floor Sq Ft Supervisor Cert # State Zip Lot Block # Lot Sq Ft Total Garage Sq Ft # of Stories_ Bldg Height # Dwelling Units 3 Floor Sq Ft Unfiished Bsmt Sq Ft Finished 135mt Sq Ft # of Bedrooms !i # of Full Baths / Baths _(D / Baths Q # of Fireplaces Q Air Conditioning Yes G 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 # List appropriate option #s UTILITIES INFO 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) X 150 Amp or Less ❑ 200 Amp ❑ Other Value of Construction (including labor material & profit)) [$ �Jboe ascription of Work %VtQ0At0 jA, O 77��/l✓u✓GDS Contact Name & Phone # of JOBSITE SUPERVISOR Subcontractor Info Electrc ' (i c �tj V�Y Vt�pAl Mechanical Framer Roofing Solar Other Concrete Other Plumbing 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 /� �i / n Print Name Phone 53 Distribution White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE