HomeMy WebLinkAbout1321 Patton St - Applications/Addition or Alteration - 07/29/2014City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Forrt Collins 281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 6 QL�Wl APPLICATION DATE ?-GM�l {
Job Site Address 13 Zl '1247 gT Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # t 1.�— S6C� 7
Last name -d- � First Name C..�3g( T-G t-l-?- Al Middle
Street Address 1 �7Z( �aATrOfJ 5-r-- City State-Z E) Zip 8 S2
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name City of Fort Collins License # C('ySupervisor Cert#
Mailing Address GflZS d�-v 2t37t '% City State GO Zip z<
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
151 Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 1/d Baths '/2 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 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 3eo 0
Description of Work: i.XX25r�G('. `Z- LfO x
Contact Name & Phone # of JOBSITE SUPERVISOR: V
Subcontractor Info:
Electrical Mechanical Plumbing
Framer Roofing Concrete Fireplace
Solar Other Other Other
Applicant: I hereby ackno edge that I ha a read this application and state that the above information is correct and agree to comply with all requirements
contained herein and Cit rt Collins dinances and state laws regulating building construction.
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Applicant Signature Print Name .4.,� �� Phone C8 -3 ��
Dist' n: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE