HomeMy WebLinkAbout1009 E Lake St - Applications/Patio Cover or Sunshade - 02/02/2012City of
F6r-t Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 8 Z �&o ` 3 (0 APPLICATION DATE C2 —9 V/O�)'
Job Site Address Wo q 6 �ale(f �- r/ — Unit #
PROPERTY OWNER INFO: (All owner Information is required - it is not optional)) Phone # /'�`- 2 v t7 5
Last name Q_ //A✓ ^/ First Name lJ-0/%�(/(l/ (,, f Middle
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Street Address l S-? Z /.70614'yax ��1` ��0� City ��t a I UI/`�J � StateC6L zip q
CONTRACTOR INFO: Company Name 91100Lre_-A�(t f �( ( i Contractor Phone # 6/f 2 -D32
Lic Holder Name //IRI C/ < (Srn V\- In City of Fort Collins License # �21 I Supervisor Cart #
Mailing Address "1�`L� �ti�ir�UF�A✓ U/� City��t C�%/�/t'/ State C� zip �p
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
1s' Floor Sq Ft
Finished Bsmt Sq Ft
25d Floor Sq Ft
31d Floor Sq Ft
# of Bedrooms # of Full Baths % Baths
Unfiished Bsmt Sq Ft _
/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 # 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) $'9W7,- 1 F 0
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
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 ordinances and state laws regulating building construction.
Applicant Signature \ l/Y� �I / Print Name �(�f( C/t'12r Phone 09-'6132
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE