HomeMy WebLinkAbout632 Agape Way - Applications/Solar - 03/10/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6 60 5-
wvvw.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER T Wk)of45 APPLICATION DATE 2)' W " I
Job Site Address Unit #/j Q/�
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 1 7 v l'y —9 d p+ -5
Last name KN;e-9gP First Name /<y�r-�— �^ // Middle
Street Address�Q f �5 q V� "/ V City ��� l Cal (fG V State (flu zip 6 J�
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing AddreE
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm] Sq Ft.
15' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
Contractor Phone #
City of Fort Collins License #.
City
Supervisor Cert #
State Zip
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/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:
List appropriate option #s
Water Tap Size Sewer Tap Size Metered: Yes or N
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only)
Value of Construction (including labor, material & profit) $ 5*00
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
o Temp. Pedestal Yes or No
❑ 150 Amp or Less ❑ 200 Amp ❑ Other
�1►A
Plumbing
Fireplace
Other
ON /�aOT
Applicant: I hereby acknowledge I have re d this a . ation and state that the above information is correct and agree to comply with all requirements
contained herein and City o ollins ordi nce state laws regulating building construction. q
Applicant Signature Print Name'/C Lr- KAlf-4-�S.� Phone I-70'"6N-936
�ut�'hite Distffice Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE