HomeMy WebLinkAbout2736 Raintree Dr - Applications/Addition or Alteration - 05/27/2015City 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 R ISO 3C13 1 APPLICATION DATE 5 - a;-) - 1,5
Job Site Address o7754 ,er A« d/ A � Unit #.
Ij
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name h4✓lmv-,r k.First Name ea- Middle
Street Address o2r7,0;G ler/�.re _41 �j / City �J! C�/��^I State el) zip
CONTRACTOR INFO: Company Name Z ��aJ•e 19f1h j1A0e` Contractor Phone
Lic Holder Name 1114A J4,4f.//"�^ / City of Fort Collins License # 3.�7U - Supervisor Cert #
Mailing Address 73i7��;, vtA /�1 &,,$/% G City (,{l.-Ar4o State e� zip B�So
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
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:
2nd Floor Sq Ft
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units &
3'd Floor Sq Ft
# of Bedrooms # of Full Baths '/< Baths
Unfiished Bsmt Sq Ft _
'/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
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) $ ✓Or/7 7,5-,7
of Work: .46C 1r vaY X01.et 4jd% Of lazlr.3 felv.4 , RPt�✓rc�� Axioklf. �Hld/ef,
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor
Info: I
Electrical FAD G�e Aoc Mechanical
Framer
Solar
Roofing
Other
Concrete
Other
Plumbing da t'A'ti.
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 ze-
Collins ordinances aJnd tate laws regulating building conssttr/uctionnn.. / /
Applicant Signature (/L_ /)44 e / Print Name /1�7( /C Phone %d ��%" ri 7�
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE