HomeMy WebLinkAbout406 E Pitkin St - Applications/Addition or Alteration - 05/12/2014COMMUNITY 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 f3f " I pr�) 30 S, APPLICATION DATE 15- 1 d " / y
Job Site Address �2)10 L= (ZNVt ray Unit #
PROPERTY OWNER INFO: ((Irv"All owner information is required - it is not optional) Phone # 9 ✓ t — l j') 5 - 113190
Last name Pr IAA t v h _ First Name wMiddle
Street Address q0% E CityFt�-J�t" . State-e�Zip
CONTRACTOR INFO: Company ame Contractor Phone # 127- 4 907
Lic Holder Name 1 n City of Fort Collins License # b- -?8 J Supervisor Cart #
Mailing Address) 743 C►GCJDYA_ n—., , City Stated Zip .53
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
D'
Residential Sq Ft /M Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/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:
Water Tap Size Sewer Tap Size
Type of Heat: ❑ Gas ❑ Electric
List appropriate option
Metered: Yes or No Temp. Pedestal Yes or No
Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
mm
Subcontractor Info:
/� [��p ���—r
Electrical 0n ^1 //'' 1�-�.t.- Mechanical Plumbing
Framer S %� l o . Roofing Concrete Fireplace
Solar
Other
Other
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 Cit f.F,o�rt`C-o'lli�s rdman�es a d state laws regulating building construction. / L' �+
Applicant Signature / ' �`yL�"�- Print Name _/1c gl �Lt�o�J� Phone X 7 107
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE