HomeMy WebLinkAbout129 N Sherwood St - Applications/Garage - 12/30/2011City of
�F6rrt Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER Imo, 3 1( 1( .5s(E APPLICATION DATE t
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PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ^ Ga
Last name `� �oyY��1 First NameV l Middle /�
Street Address \' * _ �x\/ City 11�v� State��/pZip ` D[ ZIJ
CONTRACTOR INFO: Company Name a�� Contractor Phone
Lic Holder Name S ^1 � 101� City of Fort Collins License # a9 Supervisor Cert #
Mailing Address e-_=" �� City l State Zip\
LEGALINFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) �' 7 L1(/I Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft # of Stories_L— 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 3/L Baths /: 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 # List appropriate option #s
UTILITIES INFO:
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 Am,�pgqor Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ / 7yQQ
Description of Work:
x
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical Plumbing
Framers Roofing Concrete \` M 4i 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 ordinances and state laws regulating building construction.�� tt
Applicant Signature Print Name)%` Phone Lt
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE