HomeMy WebLinkAbout3009 Avena Ct - Applications/Addition or Alteration - 04/07/2011City 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 ' I v APPLICATION DATE
Job Site Address � A I R inc, . U1- Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # l�' o� a /S '44 -106
Last name -1"� 1 t ! Z & n First Name h Y Middle ^�
Street Address ��L L 11 Q/Yvti C� City — State 0 Zip 5,
CONTRACTOR INFO: Company Nam Lt � rr L l4ro Lbkopontractor Phone #
Lic Holder Name -y1 t a r-d -Z)-) U �?��� City off- -
Fort Collins License # Supervisor Cert #
Mailing Address1b P Y 1)� City Ill o n o State(,(-) Zip R 5q
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'I Sq Ft
1It Floor Sq Ft
2nd Floor Sq Ft
# of Stories Bldg Height
31d Floor Sq Ft
# Dwelling Units
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/4 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 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) $ (( 1
Description of Work: �m, �yt,.¢ 1(�P pt � no r4w-hC a as L l ►n.P -1 " cs t."�SS'l rJs2
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: ((��
Electrical AAV nC,Q, d, CIeaf'Lr .(Mechanical
Framer
Solar
Roofing
Other
Concrete
Other
IFA
Plumbing 1,e I nL LA
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 ordinances and state laws regulating buildin2construction. 1 2
Applicant Signature lLl,(J . Print Name �6}�t pl�� Phone ��� �J��
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE