HomeMy WebLinkAbout2901 Michener Ct - Applications/Deck - 12/23/2015CVy of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER e 15y1b� 4 APPLICATION DATE ' a I a I I S
Job Site Address SDI ii%iel��'z� at.* Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name 1 O.N,Djftti S First Name aeedvk�4v Middle
Street Address C&City f--111I+ re, III State 60 zip 'E6fa4r,
CONTRACTOR INFO: Company Name ( [ <4111r6rAnl .6eu&$ Contractor Phone # (q7U) ("Pi-YO i j
Lic Holder Name 15e t4 .J City of Fort Collins License # Ii� - /!� 3 Supervisor Cert # 3c?�j'/-1) �
Mailing Address 3 �irY' I�LTvcQrP �%-�c. City �w �..�c.f State C_O zip ��53
LEGAL INFO:
Subdivision/PUD e9 J&A (4 C,w Filing # 126(1 Lot # yS— Block # Lot Sq Ft % y �/ey
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) �22 (ZL9 Total Garage Sq Ft 2t!-
Residential Sq Ft
1 sl Floor Sq Ft
Comm'[ Sq
2nd Floor Sq Ft
# of Stories ')— Bldg Height # Dwelling Units /
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft 11 L- E # of Bedrooms # of Full Baths a 3/4 Baths _ j '/z Baths i # of Fireplaces I
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: C9 or No Temp. Pedestal Yes or
Type of Heat: (SSGas ❑ Electric Electric Main Breaker Size (Residential only) 1 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ JS�COI�
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical
Framer r--4M&:_ U11 t5efuc_goofing Concrete
Solar
Other
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.
Applicant Signature �c'� _ Print Name ;� evTf eGc.,014r Phone
v
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE