HomeMy WebLinkAbout3156 Birmingham Dr - Applications/Shed - 07/11/2014City of I I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
/ www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER D T� APPLICATION DATE
Job Site Address tSl, (� scr.Mu7�P.h �z. FoeA ceg- -ks („ �po5Zi, Unit #
PROPERTY OWNER INFO: (All owner information is required - it Is not optional) Phone # 1170 - ZI7-- 7et i�5
Last name_}-\AtAcdc. First Name P%LLot4 Middle_P1P,7TV6W
Street Address '3N S(, City_ Fa Z'f (n U.l,a S State Co Zip 10 SZG
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
City of Fort Collins License # Supervisor Cent #.
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD Filing # Lot #---L-L— Block # Lot Sq Ft 1 \, U 5S
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) kG1 Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft # of Stories 1 Bldg Height \\ FT # Dwelling Units G
151 Floor Sq Ft
2nd Floor Sq Ft
3' Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/. Baths % Baths # of Fireplaces
Air Conditioning: YeGon Energy info:( Circle appropriate choice) 1. ComCheck ❑ 2. ResC heck 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 #s
Water Tap Size Sewer Tap Size Metered: Yes E]NoEl Temp. Pedestal Yes❑ No El
Type of Heat: DGas 11Electric Electric Main Breaker Size (Residential only) �150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $� 7 :K0
Description of Work: 3�»L7 ttvh. ,p, \-L I x 1LI I W -'ALL
Contact Name & Phone # of JOBSITE SUPERVISOR: C>kLLo.-f t4^t-rcocic' q 7n-Zt7-2gl S
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��� Print Name i,tL(or-r tw 4A,-teoc k Phone °I76-7I-1-7-1 I')
Distribution: White -Office Yellow -Applicant Pink - VWWV/Stormwater
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