HomeMy WebLinkAbout2921 Meadowlark Ave - Applications/Deck - 03/30/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER �' f�J 1��!/ APPLICATION DATE -3 - i Jo I I
Job Site Address ,21 Z 1 Mea.U(9w e-k Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name 41"5 00I'le, First Name Te.,-v-v Middle
Street Address r Z, / ' l e-!,.0 ow / c y � City U C . State Zip
CONTRACTOR INFG, Company Name V 10�� C_lj4 _7/ Contractor Phone # / ,20 f— 217
Lic Holder Name City of Fort Collins,,/ License # Supervisor Cert #`'
Mailing Address U/ �0 S ()LM I O(lyd 1 0ol f CLA) 1 rl t/` p 6(- State 6V Zip 0 U Jj—f -v
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.
1s' Floor Sq Ft
Finished Bsmt Sq Ft
2"d Floor Sq Ft
# of Stories Bldg Height
3rd Floor Sq Ft
# Dwelling Units
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 S. 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 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) $ y1 6U �/ /
Description of Work: R � /Z j to& , J 2- , I / 2- 17 �1 4ln. D1 / k� '� STG��J •
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
� 70 53 1- 23
Plumbing
Fireplace
Other
Applicant: I her
ackno 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 Cit of Fo Collins ordinances and state laws regulating building n uction. q
Applicant Signature._. Print N me fr_S6", Phone g2b'•j f Z��/
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE