HomeMy WebLinkAbout2909 Percheron Dr - Applications/Addition or Alteration - 02/23/2012Fort Collins
APPLICATION
Job Site Address
MV
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES.
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740�0 I
www.fcgov.com/building
BUILDING PERMIT APPLICATION ✓qqA
APPLICATION DATE
Unit #
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INFO;PROPERTY OWNER (All owner Information Is required - It is not optional) Phone # 6 - d
Last name QT F `jnjE First Name ! nf-TL Middle l
Street Address �- [ D r e; e,-e 7 L /,, rr,Ciity��� 0J/1 ins State 60 Zip ��dS
CONTRACTOR INFO: Company Name �� ` W'u(• "� Contractor Phone # �- I q O? ttr3
Lic Holder Name®��% �2���. City of Fort Collins License # -S% 3 Supervisor Cert #
Malling Address S S' City C-T— �f1t State 6D Zip
LEGAL INFO: G / 0A Ail, W)N
Subdivision/PUD �<<y I `' Filing # Lot # 1 Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) )-SO Total Garage Sq Ft
a10K
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units _
1� Floor Sq Ft 2n0 Floor Sq Ft 3'" Floor Sq Ft Unfiished Bsmt Sq Ft _
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces
Air Conditioning: Ye�]Non 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 #
- . •
List appropriate option #s
Water Tap Size Sewer Tap Size Metered: Yes ❑NoE] Temp. Pedestal Yes❑ 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
s&�prrofit) $ � it `' 00.
DescriDtion of Work: a-S 6 `'7"" �t " °"r! i/Pi r'l ��1 -"�t�Dn C &T-1vw7 ✓1 (T—6�' l
D /vv a"nb/'qti. CIflt 6.i1/)L- TA
Contact Name & Phone # of JOBSITE SUPERVISOR: 1'C' >Ire,;
Subcontractor Info:
Electrical �l✓Z�l�r�_ `�e���- Mechanical �I� Plumbing
Framer Roofing Concrete Fireplace
Solar
Other
Other
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 ordinnaf�c�es�and state laws regulating building construction. / Applicant Signature L �"�" Print Name TC�e% l� ��� Phone P LG
O T�
Distribution: White -Office Yellow -Applicant -Pink-WWW/Stonnwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE