HomeMy WebLinkAbout529 Sycamore St - Applications/Addition or Alteration - 05/28/2014City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building Pe b3g7.
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1 1 QZkO 1 APPLICATION DATE ` -7, 0 �� 1
Job Site Address�Unit #
31
PROPERTY OWNER INFO: (All owner information is required - it is not noptional) Phone
Last nameA% First Namey1�11 Middle
Street Address C mana�:�
1 City �C"1' (6 \ �1'r�t ; State 00 /pZ,ip..�1
CONTRACTOR INFO: CompanyName l C? : Contractor Phone #
Lic Holder Name )(�.�i I \\ City of Fort Collins License # Supervisor Cert #
Mailing Address City" V �lhS State (0 Zip
LEGAL INFO: rr � c I,�J p c r�
Subdivision/PUD �. {-�� / Q�,V.� 1 Filing # vV Sk Lot # Block #_Ck Lot Sq Ft�,�`i�
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) cc 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
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
2nd Floor Sq Ft
3`d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/z Baths # of Fireplaces
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
List appropriate option
UTILITIES INFO: r/
ri
Water Tap Size_ Sewer Tap Size Meter: Ye or No Temp. Pedestal Yes orb rvo'
Type of Heat: D�as ❑ Electric Electric Main Breaker Size (Residential only) 150 Amp or Less ❑ 200 Amp [:]Other
1 i , _�
Value of Construction (including labor, material 8 profit)
Des��%? ,gkrk:��O �T Oy%
Contact Name 8 Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical 1 Mechanical oziA C�51/ Plumbing olctai tz:;w2
r,
Roofing�_at { & (WV Concrete �� Fireplace
Framer �cY1
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,�: tyaf FoA ins ordinances and state laws regulating building construction. q�
Applicant Signatu Print Name �l Phone
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE