HomeMy WebLinkAbout700 Cambridge Dr - Applications/Addition or Alteration - 07/06/2015COMMUNITY 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 A fir/ APPLICATION DATE • V
Job Site Address M CLVA—V�,) k Unit # ry PROPERTY �O pWNER INFO: (All owner information is required -it is not optional) P`hoone #� /��ll l �1 -�9
Last name I V \�A11 K First Name �l i�l e ` Middle
Street AddressMCcxmor_dae TY City l ��yt CUItkns State_W__Zip ffl525
_CO ompany Name
Lic Holder Name
Mailing Add
LEGAL INFO:
Contractor Phone #
City of Fort Collins License #.
City.
State
Supervisor Cert #
Subdivision/PUD C_pktl 1.Wl 1 d Filing # Lot #_-95— Block # Lot Sq Ft _
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) / G`l `f /iaQ Total Garage Sq Ft 1i
Residential Sq Ft �%q A Comm'I Sq Ft -7 # of Stories E Bldg Height # Dwelling Units
1 s' Floor Sq Ft �t 2w'd-P�foo' q Ft q (� 3rd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms A # of Full Baths _� '/< Baths _E_ '/z Baths # of Fireplaces
Air Conditioning: es 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 #s
Water Tap Size
Sewer Tap Size Metered: Yes or
No Temp. Pedestal Yes or
No
Type of Heat: XGas
❑ Electric Electric Main Breaker Size (Residential only)
)�150 Amp or Less ❑ 20O Amp
❑ Other
Value of Construction
description of
eluding labor, material &
_>7. lC_�) CLM -.no
Contact Name & Phone # of JOBSITE SUPERVISOR:
�1y�1/JSubcontracatoor' Info:
#'Electrical r ' — 1274 Mechanical
Framer
Solar
Roofing
Other
Concrete
Other
Fireplace
Other
r�r_�Ii/I%�
"ot 1 w'n R roots
Applicant: I hereby acknowledge that) 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-coonnstruction.
Applicant Signature 4;; f/ / J� Q,4 Print Nam a 1' I} r I I �pPhone .
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE