HomeMy WebLinkAbout205 N College Ave - Applications/Tenant Finish - 03/07/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.cont/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER no sr) APPLICATION DATE (/ t w/ -� C I-" / , `a C-)
Job Site Address ;J- 0--') N, (;�, Z.c, c6 e Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # (1%-0) zi f l --6-50 (G
Last name 02 1 LK 1 /,F S First Name_ R Middle
Street Address s2 0 C/ �9 65 IM 04L't,E-6-F- CitC State-L—OZip F0
CONTRACTOR INFO: Company Name �G� c IN4NYt16 £ /Gf Enaf Contractor Phone # �9%D)�,-9-(d l d
Lic Holder Name <���
,�n�City of Fort ollins License # Supervisor Cert #
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Mailing Address Pi- x - .47,- 11F 6 1-1"4- State 005 Zip 0-5-0-
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft J(S # of Stories Bldg Height # Dwelling Units
111 Floor Sq Ft /6 !; 4 2"d Floor Sq Ft 3rd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished 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 # List appropriate option #s
UTILITIES INFO: 1, 9u -t
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. pedestal Yes or ' No�
Type of Heat: pas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 1 0 Amp or Less
Value of Construction (including labor, material & profit) $ 3 cry 2 1 +I7-EI?Al
Description of Work: T$y J4 n/ / F: y l < H K t � )iL! - e 6 r)
L f C fi'--t[ dV /—^ —Pao„ L) A: PU v st-f t3 i� . 16 'r S`6 K+
B ' i) `
Contact Name & Ph ne # of JO
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Subcontractor Info: F�—
Electrical
Framer
Solar
A
SUPERVISOR: T� H ti P C5ie
-/'C
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowle a 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 Fo Collins or
din and state laws regulating building coonn'struction.
Applicant Signature ' Print Named 4N �/j G %��- Phone ,5 S �p l0
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Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE