HomeMy WebLinkAbout415 Pearl St - Applications/Shed - 12/31/2013City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov corn/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBERU/3®pgJ/ APPLICATION DATE 1431I13
Job Site Address 41-5 77Lju- ST Unit #.
PROPERTY OWNER INFO: (All owner information is required -it is not optional) Phone # 0170 . 45 al . n-ffl�t 8 &
Last name 5�U1��Q First Name Kai Middle
Street Address 4 its C City�%ni2j e�LU ZQ5 State e-0 Zip &750
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO: i
Subdivision/PUD F b*W, FAP p.{--�- Filing # Lot # /0-5 Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
151 Floor Sq Ft
2nd Floor Sq Ft
,ent) Total Garage Sq Ft
# of Stories Bldg Height - %&9 # Dwelling Units
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/z 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) $ g2-00
Description of Work:
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 o dinances and state laws regulating building construction. /
Applicant Signature Print Name m;r32 Phone
a
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE