HomeMy WebLinkAbout5410 Apple Dr - Applications/Addition or Alteration - 09/20/2013COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
City of
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/bu i Id in g
BUILDING PERMIT APPLICATION
APPLICATION NUMBER r I �J V "7�' 3 APPLICATION DATE Vim' I
Job Site Address b APPe: fl2 Unit #,
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name J ONES First Name J`(i}/✓0 `7 Middle
Street Address Sq!O &00'�_ b/1 City Fr Cate-5 State en Zip %oSZ-('
CONTRACTOR INFO: Company Name WtN0Ov✓S I'�l�"tCit LA Contractor Phone # 303-1 Zo -0175-
Lic Holder Name LILY 6 is S L AAwt 6eN City of Fort Collins License # Supervisor Cert #
Mailing Address %'iS S
w. It � hvy- 057 City fv♦♦/AK&trA✓/V State Cd Zip 96FZ34F-
LEGAL INFO:
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
ls' 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 S. 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)
Description of Work: tfTrNG gjIEMLNT VVt/"76v"� 7-4
E%,u FS t^pD E
Contact Name & Phone # of JOBSITE SUPERVISOR: et-gb & J . Lv.YA 6tE7,--'
Subcontractor info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge that I have read thi application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Col/1i9� or 'hanc n state laws regulating building construction. CGLL,i,'
Applicant SignaturPrint Name &0.J. `-V eOagYL Phone ?03'2-` 1'VV2_F
Distribution: White -Office Yellow -Applicant Pink -WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE