Loading...
HomeMy WebLinkAbout220 Peterson St - Applications/Addition or Alteration - 05/08/2012City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES FOI t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 / - www.fcgov.com/building It I� � (d BUILDING PERMIT APPLICATION APPLICATION NUMBER ✓ V CR APPLICATION DATE AA ca y Job Site Address J Q b P e c-g 0 n S 1-. Unit)( -A pck c- t+1 e n� P i k; PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # q 1 Q — --2 Last name AN©C CV- e First Name Middle F o 6, e,r Street Address 0907 DIA3,1 c) e e C}• City 1-e r Cod `1 n s State_ro Zip a 3�> CONTRACTOR INFO: Company Name ff\a n kG'ac } rn T-: v%m Contractor Phone # Lic�er Name r 1 ' City of Fort Collins License # IV f%� Supervisor Cert#y\lc— Mailing Address Zia57, S r "„ 5 e t• City 1— � Co . n State G D Zip 8 0-:5.2 I LEGAL INFO: Subdivision/PUD Filing # Lot #. CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Residential Sq Ft Comm1 Sq 1s' Floor Sq Ft Finished Bsmt Sq Ft 2nd Floor Sq Ft Block # Lot Sq Ft Total Garage Sq Ft # of Stories Bldg Height # Dwelling Units 3'd Floor Sq Ft # of Bedrooms # of Full Baths 3/4 Baths Unfiished Bsmt Sq Ft _ % 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) $ Y IT s. Dy Description of t;(4) L ,I r � Contact Name & Phone # of JOBSITE SUPERVISOR: a7 , 910 - 9 3 Oy O 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 ordinances and state laws regulating building construction. Applicant Signatur�av:!t, 1� l�l cam-- Print Name__ I-- k icw r- " Z f ly r9 oce Phone oi10 Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE