HomeMy WebLinkAbout210 Circle Dr - Applications/Addition or Alteration - 12/06/2010City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416.2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER t (On 09, • , APPLICATION DATE W6(1 3
Job Site Address 210 CIRCLE DRIVE, FORT COLLINS, CO 80524 Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 970-308-7885
Last name CLINE First Name LEANNE Middle E
Street Address 210 CIRCLE DRIVE city FORT COLLINS State CO zip 80524
CONTRACTOR INFO: Company Name NSA Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City
LEGAL INFO:
subdivision/PUD 1021- CIRCLE DRIVE (#19711) Filing #,
State Zip
Lot # 57 Block # Lot Sq Ft
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
15' Floor Sq Ft
2"d Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths Yz Baths # of Fireplaces
Air Conditioning: Ye�]Non Energy info: ( Circle appropriate choice ) 1. ComCheck11 2. ResCheck w/Air Sealing ❑
3. ResCheck w/Blower Door F1 4. Simulated Performance Alternative❑ 5. Prescriptive w/Air Sealing11 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes FINoll Temp. Pedestal Yes❑ No
Type of Heat: Gas1-1 Electric Electric Main Breaker Size (Residential only) Ill50 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $ `)o 0
Description of Work:
FRONT PORCH ADDITION - APPROXIMATELY 19'X9', GABLED
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
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.
Applicants , r Print Name W1 P106 ("e- iyC Phone _"i1Q''�- -i1RfSS
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE