HomeMy WebLinkAbout7319 Silver Moon Ln - Applications/Deck - 04/21/2014COMMUNITY 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 I A O L 100 APPLICATION DATE {
Job Site Address �j Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ( { 7b —(op —10 i c i
Last name �` First Name PNN17 Middle �.
Street Address c� 1 (riiX �City� I OI ,415 State
CONTRACTOR INFO: Company Name
Lic Holder Name
Contractor Phone
City of Fort Collins License # Supervisor Cart #
Mailing Address
LEGAL INFO:
subdivision/PUD Gteefl-�V`Q. Filing #.
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq Ft
State Zi
Lot # OA6 Block # Lot Sq Ft ) 81 O
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft 2nd Floor Sq Ft 3r° Floor Sq Ft Unfiished Bsmt Sq Ft
Finished 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:
List appropriate option
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) $ Q 4S , 60
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledg 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 , Ciallins ordin a d state laws regulating building constn ction. 'C J /
Applicant Signature ! Print Name v &I hone El F� !ol
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE