HomeMy WebLinkAbout216 Linden St - Applications/Addition or Alteration - 02/08/2012BUILDING PERMITS & INSPECTIONSDIVISION
P.O. Box 580 •Fort Collins, CO 80522-05800580 - Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER a I �.O 6 k�` APPLICATION DATE���
Job Site Address 'a 1 G L %ytc n Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # /`%O'
Last Name k4;1 zr-o1✓d First Name J t,,j o 4- 1 Middle
Street Address :34,A3 CAr} 4,e21. 6y RX IV y City CD//, %)-S State zip cRfO-5--Z
CONTRACTOR INFI/O: Company Name a�rf ontractor Phone # 5�93 —3 5�99
Lic. Holder Name I,..- ee, City of FortCollins License # (- Z Supervisor Cert #
Mailing Address 20 11 4>X 2 51-1� City /3e,!lv&,r— State4!�-6 zip
LEGAL INFO:
Subdivision/PUD %OD/Z Filing # Lot #�� Block #__/Z Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) �Z .70 Total Garage Sq Ft A--x.¢
Residential Sq Ft Comm'I Sq Ft14 /70 # of Stories Z. Bldg Height 30 # Dwelling Units IV
1st Floor Sq Ft 2^d Floor Sq Ft ;,r'6-/Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms !i # of Full Baths % Baths Yz Baths 2. # of Fireplaces
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. Corri 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 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 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) $ G 7 d60 .
,,ii � f
Description of Work:: r�jnrIC i 'G& C e-A C PG<tana4 ri
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical & rk,45 A�r�f n L Mechanical Plumbing
Framer �il�/�t -� I n ,,,r,6,r r n Roofing Concrete 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 Cit rt Col'ns ordin nces and state laws regulating building construction.4 �'`3
Applicant Signature /IA/1�� Print Name{I Jf(A J.) , Phone -ZM
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE