HomeMy WebLinkAbout602 Edwards St - Applications/Addition or Alteration - 11/26/2014City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
wwwAcg ov.co rn/bu i Idin g
BUILDING PERMIT APPLICATION
APPLICATIONNUMBER bR\JW APPLICATIONDATE,
Job Site Address in OZ / & l.u4rA� 5 Unit
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name r)�I G ,j rl,l First Name A LlA Val q C Middle '—
Street Address (r7� Z LEI LUGr� City �6f4- c6 f Iih C State 6 _zip cbsZ�
CONTRACTOR INFO: Company Name Contractor Phone # In -TZl - 097Z
Lic Holder Name Q6CI •ke r j iCHSe rnJ City of Fort Collins License # Supervisor Cert #
Mailing Address 226 & , 111�i I bernn Ave City i-4 , 6011I rlS State60 zip g0sz
LEGAL INFO
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft 06 fo� ,Comm'I Sq Ft
,
1s' Floor Sq Ft &b `�! 2"d Floor Sq Ft
Finished Bsmt Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3% 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 #
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) $ )) i 000. do
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical V
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. /�Q /J
Applicant Signature 0 r' t Cif / Print Name�Jd� l 11 0, `W q Phone C%7C/ — 510 -7& y 3
Distribution: While ice Yellow -Applicant Pink -WWW/Stonnwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE