HomeMy WebLinkAbout900 Marble Dr - Applications/Addition or Alteration - 05/08/2015Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER �� �✓ APPLICATION DATE f
Job Site Address qoc) i4vt/f ,3•-Lju i •• <<?I '�s�C a Unit #
PROPERTY OWNER INFO: (All owner Information is required- It Is not optional) Phone #
Lastname RAnr(�t/ First Name S L o`T�f Middle 91
Street Address q ou /KA'1 G/ /2)/1 ' / Z City EPE co l Eci s State ':�y zip Fr C-' '-d (0
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
City of Fort Collins License # Supervisor Cart #
Mailing Address City State
LEGAL INFO:
Subdivision/PUD Filing # C 714 Lot # .2 Block # Lot Sq Ft
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
151 Floor Sq Ft 2n" Floor Sq Ft 31' Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths % Baths # of Fireplaces
Air Conditioning. Ye&on Energy info:( Circle appropriate choice) 1. ComCheck ❑ 2. ResCheck w/Air Sealing ❑
3. ResCheck w/Blower Door ❑4. Simulated Performance Altemative❑ 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes ONo❑ Temp. Pedestal Yes❑ No 4
Type of Heat: MGas ❑Electric Electric Main Breaker Size (Residential only) 11150 Amp or Less 14 200 Amp ❑Other
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Value of Construction (including labor, material & profit) $
Description of Work: r// EA i /9c crtii rkA i i rr/j 0F 140
Contact Name & Phone # of JOBSITE SUPERVISOR:
Electrical c+�^r Mechanical /V1A
Plumbing 11/14
Framer r._,—� Roofing 0 -✓,j �—t Concrete iZn Fireplace
Solar
Other
Other
Other
Applicant: I hereby acknowledge that I have read this application and state that the above information is coned and agree to comply with all requirements
contained herein and City of Fort Ifins ordinances and:stdte laws regulating building construction.
Applicant Signature l «/ Print Name Ce-u7l_ �• 9NC/ Phone 9 70
i
istribution: White —Office Yellow —Applicant Pink —W W/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE