HomeMy WebLinkAbout1901 Longworth Rd - Applications/Solar - 06/06/2012City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER �' 2' ✓� � APPLICATION DATE_ _ ( ~ 0 — I —
Job Site Address Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #_?Hn—
Last name L f Ei First Name le Fl Middle
Street Address I YO / LD.V C- tA-OR Tji City PORT C04'41'4e5 State C�O Zip 9asZG
CONTRACTOR INFO: Company Name 60A.1,0 Contractor Phone # 7yD - 534; 5Z9
Lic Holder Name 6,et^N .6P—y6GFirm v City of Fort Collins License # Supervisor Cert #
Mailing Address It 700 ST,Et4/�C- 0- City /SdvG�l/e State EO Zi3a q
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq
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
1s' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
20d Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/. Baths /z Baths # of Fireplaces
Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
List appropriate option #s
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) $tea (y e)
cl£
Description of Work: rl 05,4 ,#f97 /1'f 0 O.t/ A00 F 901,,4 /� IL'LEC lIe f C
5" nF_44 , Ato cfr✓rE d d ti pa&us . 7, .73 A-W
Contact Name & Phone # of JOBSITE SUPERVISOR: AIt/A.✓ /J,euGK-LM " -, 9;W -3d q— y 73 3
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 o on Collin ordinances and state laws regulating building construction.
Applicant Signature �i,/�iL_ Print Name �Ji2/itN �%L(/yL�il�4.� Phone
Distribution: White — Office Yellow— Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE