HomeMy WebLinkAbout3330 Dunbar Ave - Applications/Addition or Alteration - 02/23/2012COMMUNITY 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 1 _ �1 `I I APPLICATION DATE (7�D I a I o�
Job Site Address 3'UN[3A(2 Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #
Last name 44AX i/l ELL- First Name Eu%[= /U[— Middle
Street Address 3 � UN n AXZ City FTO la: CnLe , l kl S StateCf& Zip aQ a2�
CONTRACTOR INFO: Company Name A V { 4_r-n/J.S rrZt-)MQ VContractor Phone # 17ZO 6ci636!1 7
Lic Holder Name 1(;FF LID 4 VI-5 City of Fort CollinsLicense# 7)—2 5.3 Supervisor Cert#
Mailing Address 1021 AI E5 -1 7J i21 UE City fT ler (/fJ(.LJ./O(,S State_ Zip (!05';P—¢
'l- LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
151 Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
Filing # Lot # Block # Lot Sq Ft
ement) Total Garage Sq Ft
_ # of Stories Bldg Height # Dwelling Units
3r° 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 #
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) $42-500
i I • • / G Stt-W G i .=
Contact Name & Phone # of JOBSITE SUPERVISOR: j tz F Dm ul:5 970 660 -13117
Subcontractor Info:
Electrical
Framer 7 U(5 CC A),5 M Roofing
Solar Other
Mechanical
Concrete
Other
Plumbing !'5PLUMR(A/(
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 e� r , 64 ` PrintNamer f�-ff �7�!(!1S Phone!?70-GW--
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE