HomeMy WebLinkAbout311 Riverside Ave - Applications/Single Family New - 08/27/2015City 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 3 1 6v U 3 Ct APPLICATION DATE ?) ��� — I J
Job Site Address del ,j<1i%5cC-;9-
+kzkj�AS 6052�l Unit #
owner information is required - it is not optional) Phone # 7 /t)- 4p" { 6A ` p
Last name WlAe-o�
First Names r�
Middle
Street Address;
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ae
City��, l�`I'�-�
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State _Zip �6
CONTRACTOR INFO: Company Name . o �i Contractor Phone #,
Lic Holder Name
Mailing Address
LEGAL INFO:
City of Fort Collins License #.
City
Supervisor Cert #.
State Zi
Subdivision/PUD Filing # Lot # Block #�1 Lot Sq Ft ,(094
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) .1�1� L.. Total Garage Sq Ft
/a3a
Residential Sq Ft Comm'] Sq Ft l#�of Stories L Bldg Height 4-7 #Dwelling Units
15l Floor Sq Ft SyJ2�nd Floor Sq Ft 7 � 3r Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft 1A # of Bedrooms ___L # of Full Baths % Baths '/2 Baths �_ # of Fireplaces
Air Conditioning: e 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 Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option a
UTILITIES INFO:`-�
Water Tap Size_ Sewer Tap Size Metered Yes or
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only)
Value of Construction (including labor, material & profit)
F�
of Work:
No Temp. Pedestal Yes or No
1.50 Amp or Less ❑ 200 Amp ❑ Other
Contact Name & Phone # of JOBSITE SUPERVISOR: C \_ Ac S0C 7D to L l 7
Subcontractor Info: Electrical' �MechanicaltitA(kdq Plumbing I
Framer Roofing ��, ` , Concrete Fireplace N I A
Solar NIA Other
Other
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 Col' Zs.em4 m* and state laws regulating building construction.00
Applicant Signature Print Name�e l �0! Phon ("C� �ip�0'VV,
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE