HomeMy WebLinkAbout1112 E Pitkin St - Applications/Addition or Alteration - 03/21/2011COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
City of
F6rt Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER B I ly` O 8 0 APPLICATION DATE —3/� [ � I
Job Site Address II ►a- C• I+K1, St. j. CoIIIn5 CC $�:V'JUnit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional)-t Phone # -70—3 (a' i 3
Last name M PrE-8-NO A tJ First Name R-1 M Middle �)
Street Address I 1 E .P I ski n 5+- City i" k . 60 < t nS State C-V Zip -%OSay
CONTRACTOR INFO: Company Name OWK-¢.V— Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO: /� Q
Subdivision/PUD1)r I yjeir5i�A �CX�S l Filing # Lot # 3 a-j Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 'QL'9 Total Garage Sq Ft
'
Residential Sq Ft Comm'I Sq Ft � # of Stories_ Bldg Height %5/ #Dwelling Units
1st Floor Sq Ft li 7g7) 2nd Floor Sq Ft n 3rd Floor Sq Ft rn Unfiished Bsmt Sq Ft Ig 9L—
Finished Bsmt Sq Ft 100 5 # of Bedrooms # of Full Baths 3/4 Baths '/2 Baths # of Fireplaces _(91
Air Conditioning: Yes (�D 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:
//
Water Tap Size Sewer Tap Size T Metere es r No Temp. Pedestal Yes or No
Type of Heat: E Uas ❑ Electric Electric Main Breaker Size (Residential only) gl50 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)
A
Subcontractor Info:
ElectricaacQA okf4kpaj Mechanical
Framer
Solar
Roofing
Other
Concrete
Other
Plumbing Ad I-Ln Pfu n-bA-4A
Fireplace
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 o dinances and state laws regulating building construction.
Applicant Signature 9J ` Print Name s ^ 17• / v 1� raµ• I a — Phone 9 �b a<g��y�?
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE