HomeMy WebLinkAbout1905 Sequoia St - Applications/Addition or Alteration - 01/27/2012City of
Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgovcom/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DAT<E
.JUD 0RV P%UUfr;55 ' 1v � JT�s.(,v v�y . 1 c�0 .,, V111L It
PROPERTY OWNER INFO: (All owner Information Is required - It Is not optional) Phone # Co 3 �-" g�o4g f✓1�i
Last name C-=ry! .'l%— - First Name W�1 Middle
Street Address �� 0�7 S�-�y���' Ste' City �� CA1 5 StateG� Zip
CONTRACTOR INFO: Company Name JD!—�plzza5� 1U I/ Contractor Phone # 221— �v�2Z C-Aall
Lic Holder Name 1 1J�TV�% •�'V'C�' City of Fort Collins License # t9 Supervisor Cert #
3�1 S G�t� Ci �rl' Coin to St�SZ t
Mailing Address i City ✓State Zip i
LEGAL INFO:
Subdivision/PUD Filing # 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
11 Floor Sq Ft 2"d 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 Doo
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
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) $
l'd J
Description of Work: inSri
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�Qs- 1Jc�1�ri
Contact Name & Phone # of JOBSITE SUPERVISOR: J 4z 1 *_=�
Subcontractor Info:
Electrical 11.4 Mechanical Mld
Framer) b Iffr-. Roofing
Solar
Other
Concrete
Other
Plumbing
—
Fireplace
Other
Applicant: I hereby acknowledge that I have reaq this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of F ollins ordinan es and st to laws regulating building construction.
Applicant Signatu Print Name Phone
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE