HomeMy WebLinkAbout3355 Oregon Trl - Applications/Patio Cover Or Sun Shade - 06/17/2014COMMUNITY 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 O 22-D5E) APPLICATION DATE
Job Site Address [)reer► 1!(',rI 4(r)fjlm� 60WAUnit#
PROPERTY OWNER INFO: (All owner informal o 'is required -it is not optional) Phone #
Last name C(�o First Name - CI)SelMiddle /Ic4A.
T l
Street Address 3355 �_T1 I ti I City' 1 State—CD—ZipM�26
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
Mailing
LEGALINFO:
City of Fort Collins License #.
City
Subdivision/PUD Filing #
Supervisor Cert #
State Zip
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 # of Stories Bldg Height # Dwelling Units
1$t Floor Sq Ft
2nd Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths /z 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) $ '2A'4 -1
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
12 x16
_Zzf- M
_ 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 Collins ordinancg# and state laws regulating building construction.
A C ��-zz���s
Applicant Signature _ - r Print'Name Phone��
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE