HomeMy WebLinkAbout6602 Avondale Rd - Applications/Single Family New - 01/06/2016.Fort CoWns
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APPLICATION NUMBER
COMMUNdTY DEVELOPMENT & NEOGHB®RH®®® SERVICES
281 N. GAIlege Ave. o Ford Collins, CO 80522-0580 o Phone.- 970-221-6760
wwvvAcgov.com/building
BUILDING PERMIT APPLICATION
Job Site Address 66a_R_Aonc41v! dn,�6_
APPLICATION DATE /_ (19-1
Unit #
PROPERTY OWNER INFO: (All owner information is required -it is/not optional) Phone # �?70 - 7',�d - a' 6
Last name /fFirst Name ��b�ry�z,�— Middle
Street Address J s , 2 l�a/ City j5, LO /i '05 State C�_Zip p 2
CONTRACTOR INFO: Company Name f�/��. ey17 Contractor Phone # q7D �qb
Lic Holder Name , / City of Fort
ej>
Collins License ;l (oSupervisor Cert 91//,S=,,D
Mailing Address � �G' City P-f 1 / n S State LD Zip 6 7 �o—
LEGAL INFO:
Subdivision/PUD A gr If 1� Filing # Lot # Block #
CONSTRUCTION INFO__ Total Building Sq Ft (not including basement)
Residential Sq Ft -�6 (p-[ Comm'] Sq Ft # of Stories
1 ti' Floor Sq Ft _ 2"" FlooVSq Ft � _ 311' Floor Sq Ft
Lot Sq Fto? �v
i� Total Garage Sq Ft _ C-IU
Bldg Height_-77 # Dwelling Units
Unfiished Bsmt Sq Ft 71qr
Finished Bsmt Sq Ft / I! of Bedrooms t/ of Full Baths 3/4 Baths / Y2 Baths 1t of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door l imulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option Its
UTILITIES INFO:
Water Tap Size Sewer Tap Size K Metered Yes or No Temp. Pedestal Yes or No
Type of Heat: as ❑ Electric Electric Main Breaker Size (Residential only) 50 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)
Description of 1
S;
Contact Narne & Phone tl of JOBSITE SUPERVISOR:a?�i4
Subcontractor Info:
Electrical Lacey 14 Mechanical di �/ _ _ /T1 Plumbing
Framer f��/}F Roofing J Concrete Fireplace
Solar 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 CitRa
rdinances and state laws regulating building construction.
Applicant Signature ZPrint Name- inL Phone 3k
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwaler