HomeMy WebLinkAbout222 Linden St - Applications/Occupancy - 10/25/2011City of
Frt Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER l C�� (14 ni APPLICATION DATE
N,
Job Site Address
6� Unit #J-Q_01.,
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # 1-1 C) — 6) 19 " t I (ob
Last name First Name II Middle
Street Addr ss f 1. City eAL &s State -&--Zip _
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
Mailing
LEGAL INFO:
City of Fort Collins License # Supervisor Cert #
City State Zip
Subdivision/PUD Filing #.
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm] Sq
1s' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2ntl Floor Sq Ft
Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3rtl Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/z Baths # of Fireplaces
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
Water Tap Size Sewer Tap Size
List appropriate option
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) $
of
6:he
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical /�
Framer /v Roofing
Solar Other
Mechanical 6 I'I Plumbing r"lll�--
Concrete
��.
Other
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 or finances and state laws regulating building construction.
Applicant Signature_d A Print NameC-�Lf l), ���� % Phone
Distribution: Whited ice Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE