HomeMy WebLinkAbout737 Butte Pass Dr - Applications/Electrical - 05/31/2012City of
/' oV rt 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 �l dL D� c�+��APPLICATION DATE -/311 /a
Job Site Address 73 7 L?tA Miss Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 9%' NU l- tf 7N
Last name k/I L COm First Name Middle
Street Address Aft 73 EuA PP s1 City FAT Cok+`— i State C 4 Zip 5bSa>g
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address
LEGAL INFO:
Contractor Phone #
City of Fort Collins License # Supervisor Cart #.
City.
State Zip
Subdivision/PUD Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Sty Total Garage Sq Ft 1/ 6O
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
161 Floor Sq Ft
2nd Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft qq
Finished Bsmt Sq Ft 7 60 # of Bedrooms # of Full Baths 3/. Baths Yz Baths # of Fireplaces
Air Conditioning: Yes l% 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 #
UTILITIES INFO:
List appropriate option #s.
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: gGas ❑ Electric Electric Main Breaker
gqSize
��(Residential only)) —❑1 150 Amp or Less ❑ 200 Amp ❑Other
Value of Construction (including labor, (material & profit) $ a40-6— Q_� n, J 1 I
Description of Work: RA.1� t-f% P ���+, "�+ kOr I- kA�
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
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 or ' a state laws regulating building construction.
Applicant Signature K Print Name 41 fLw r' Phone 9%� tf01'yi�i%
Distribution: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE