HomeMy WebLinkAbout1313 Blue Spruce Dr - Applications/Addition or Alteration - 12/16/2011F6rt
Cityoff COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER / APPLICATION DATE / C�— . /�✓ ✓//
Job Site Address l %� NUZ," /Orvice: P-7 Unit # T-?> —1
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # !27a --!Z
Last name �Si (�-�� First Name S-Af-t -yl Middle
Street Address l 31 3 ,6 "4 Y f� _ City fi?,-- CoL1in S State � Zip
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address
LEGAL INFO:
Contractor Phone #
City of Fort Collins License # Supervisor Cert #,
City State Zip
Subdivision/PUD Filing # Lot # Block #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 7--�
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height_
111 Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
31d Floor Sq Ft
Lot Sq Ft
Total Garage Sq Ft
# Dwelling Units
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes 1L.9 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
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) $ 1500
Description of Work: C/ 4_-T/- - -f-7 rj,%-►y,--
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Mechanical
Plumbing
Framer Roofing Concrete Fireplace
Solar Other c Othkl(. �p him
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 building construction. GG
Applicant Signature Print Name STF'- \L S&k(s, Phone 000 �1�'4 - 5 j
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE