HomeMy WebLinkAbout408 Junco St - Applications/Deck - 04/12/2011F6rt
Ci�tyof COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 �,��
wvvw.fcgov.com/building ,
BUILDING PERMIT APPLICATION
a�
APPLICATION NUMBER I V 1CQ APPLICATION DATET
Job Site Address �Ls OLL0 CIC Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #
t
Last nameFirst Name Middle
Street Address VA -j—Z n t-V City rer)r t��\t�� State 4.+ zip�`_�
CONTRACTOR INFO: Company Name�p�r.,� � f 4'tnc� Contractor Phone # 7 !> 301� —p5-3 m
ll
Lic Holder Name i7eet t. %1A,r>>Lt`�— City of Fort Collins License # V-�g*:t- Supervisor Cert # s&Ar• -b\
Mailing Address 9xcs^cCfll9r�l - City Lslr-� State Zip
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement
Residential Sq Ft
15' Floor Sq Ft
Finished Bsmt Sq Ft
Comm] Sq
2nd Floor Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
31d 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:
Water Tap Size Sewer Tap Size
List appropriate option #s
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) $ 4 0010
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
G.PLC, 4- L?
I
Plumbing
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 Collim ordipances and state laws regulating building construction. Applicant Signature f Print Name V y (�L/ �� Phone Fh /1r��
9V 4'OL�' V-
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE