HomeMy WebLinkAbout1518 Brentford Ln - Applications/Addition or Alteration - 04/02/2012City of I I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER U 92 APPLICATION DATE
Job Site Address l 51 A 84EAITFORD /A/E�� 5� 5 U-7n'iit'�# Z2& 7 7
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # -9 / 0. 23 J 9 T T
Last name A1Ej %DVZR First Name JO%%,tl Middle
Street Address 2!0/4J -TiM��RL/�/E /b -�t�l city )!&r AllIA1.S State-.Cff zip f30525
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
Mailing
City of Fort Collins License #.
City
State
Supervisor Cart #.
LEGAL INFO: �(
Subdivision/PUD /��/ ��10��� PL�� ,Filing # n Q ,1Lot # Block # Lot Sq Ft 1462 5
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) J () V Total Garage Sq Ft 119 /Q
Residential Sq Ft9 Comm] Sq Ft 7 M # of Stories Bldg Height # Dwelling Units
1 s' Floor Sq Ft 2630 2nd Floor Sq Ft /3 a 3rd Floor Sq Ft � Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft JI / Q # of Bedrooms 5 # of Full Baths - '/. B/2 /
aths Baths / # of Fireplaces
Air Conditioning: Ye4on 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 RNor-1 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 & profit) $ 2 C , 00
of
Contact Name & Phone # of JOBSITE SUPERVISOR: J- 6/•/A ke/, j rp&k 9 T Q. 231, ✓ J 71
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknow g that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and Ci of Fo C 01i rd' weg a d sta ga building construction.
Applicant Signature Print Name Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE