HomeMy WebLinkAbout329 Edwards St - Applications/Addition or Alteration - 05/01/2012COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
APPLICATION NUMBER r I
Job Site Add
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
ra111149LA1101 1
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not ootiona0 Phone # C %Z) iT, -Z7_4�
Last name lF4Z� r A.)I First Name ���'L Middle
Street Address /mom CZ— City-r]�4t 1 y4-a State--T—�Zip /
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Na City of Fort Collins License #_�_ Supervisor Cert #&rn�
Mailing Address z�7 City State (L'—CD Zip�C:R��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
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/. Baths '/s 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 #
UTILITIES INFO:
List appropriate option
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) $ / O6>
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR: �E8
Subcontractor Info:
Electrical Mechanical Plumbing
Framer Roofing Concrete Fireplace
Solar Ot Other Other
Applicant: I here7and
nowledge t at I hav read this plication and state that the above information is correct and agree to comply with all requirements
contained hereinty of Fort C Iins or nances d state laws regulating building construction.
Applicant SignPrint Name Phone
tribution: W 'e- Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE