HomeMy WebLinkAbout2212 W Olive Ct - Applications/Addition or Alteration - 09/07/2011City of ° COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N. College Ave. * Fort Collins, CO 80522-0$80 a Phone: 970-221-6760
WWw fagov aonii/building
BUILDING PERMIT APPLICATION
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APPLICATION NUMBER L� L `' - - APPUCATIONDATE
Job Site Address 21&I Z . b11 V� (" • _ _ Unit#_______ -
PROPERTY OWNER INFO: (All owner Information is required - It is not optional) Phone #
Last name � __- __ First Name &*i _ Middle �,S(G
Street.Addrest2212 -Ls - r litcf,_____ U. City"t__ (o [(,US State 2 Zip _
CONTRACTOR INFO: Company Name Contractor Phone #,
tic Holder Name _ _ __---- _ City of Fort Collins License # Supervisor Cert #
Mailing Address City- -- _ _ _ -- _ -- ._ -- _-_ _State _ _. Zip
LEGAL INFO:
Subdivision/PUD J I q S1 -Te� (eti1 _ Filing #. S/ � .Lot #� Block #_Z_ Lot Sq Ft W Z
CONSTRUCTION INFO: Total Building Sq Ft (not Including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories - Bldg Height _ _ _ __ _ # Dwelling Units
1g' Floor Sq Ft _ 2nd Floor Sq Ft: 31d Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft. # of Bedrooms # of Full Baths _ i % Baths _ '/2 Baths _ _ _ _ . # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ConnCheck 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) 150 Amp or Less ❑ 200 Amp ❑ other
Value of Construction (including labor, material & profit) $ "t . b 1S50
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Description of Work:
Contact Name & Phone# of J09SITE SUPERVISOR: {W'�314!fj Cob Kcs.4%s
Subcontractor Info:
Electrical. _ Mechanical
Plumbing
Framer Roofing Concrete.. Fireplace
Solar Other _ _ _ -_ Other 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 Signature1;=_::CId
_ Print Name /L C__ MAC44-s Phone 02 - .
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE