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HomeMy WebLinkAbout1218 Brumal Ct - Applications/Electrical - 12/04/2015i City ©f Fort Collins APPLICATION COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 r www.fcgov.com/building �1J BUILDING PERMIT APPLICATION��� Ax)- . APPLICATION DATE IQ ` q- I.5 Job Site Address ! /SS 9A7 v 1-' sly cT FgPT co1C1 -fUnit # *PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 1 70 Last name / 5,Z C(- First Name L -9EL Middle b Street Address /2 /0 7- City FT CoC L/rf State CC zip b' O SAS' CONTRACTOR INFO: Company Name Lic Holder Name Mailing AddreE LEGAL INFO: Subdivision/PUD Contractor Phone City of Fort Collins License # Supervisor Cert #. City. Filing # Lot #, State 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 1�1 Floor Sq Ft Finished Bsmt Sq Ft 2�.d Floor Sq Ft 3m Floor Sq Ft Unfiished Bsmt Sq Ft # of Bedrooms # of Full Baths '/4 Baths '/z 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 -P-Value of Construction Li cluding labor, mat rial & profit $ 764V E lCeiri . [f�Sv .`,jG`' f rG• �.d�w u4�� 51; tLe� �L S i JYY- 1 vi r�e.r. Description of Work: lZ0--1 It- 11 To ACC, fS'LAr(7, 7FAP Dc✓('A90 yS v g04 RCyJT 7-� R A n)AtiT !- ti nFs 0l1 2V06 v?95f/ Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical Framer Roofing Solar 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 ina s and state laws regulating building construction. Applicant Signature ��Print Name L s4Z L d"%e:/26F Phone Q 7 0 y.Za- / J/.Z Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE