HomeMy WebLinkAbout2936 Council Tree Ave - Applications/Electrical - 03/17/2016From
03/07/2016 15:40 #323 P.001/001
Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 870-416-2740
vvww fcgov corn/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1.> 1 K! O (S I J APPLICATION DATE
Job Site Address 2oi 3(0 CIA2IA Cl I Tiry' Aw- Unit #
PROPERTY OWNER INFO: (All owner Information Is required- It Is not optional) Phone #200 4qQ d(P 8d
Last name i" Cdr Ued �F!rstNam�p Middle
Street Address City l'I t�Q D I 1 5 State,—� Zip�5
CONTRACTOR INFO: Company Name � 1 UArtCdQL :5 �Q1t011A Contractor Phone $A3n 7�01 [41 `7(o
Lie Holder Name � C1 of Fort Col ins License �i v!(� C f � � �tt+fi n ry �_ Supervisor Cert #
Mailing Address f�l �1 � �I • City.En State C10 Zip :9O H
Subdivision/PUD Filing # Lot # 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" Floor Sq Ft 2°' Floor Sq Ft 31' Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths Y2 Baths # of Fireplaces
Air Conditioning: Ye flNo Energy info:( Circle appropriate choice) 1. ComCheck ❑ 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door11 4. Simulated Performance Alternative[] 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option #s
Water Tap Size Sewer Tap Size Metered: Yes ❑NoE1 Temp. Pedestal Yes❑ No ❑
Type of Heat: a Gas ❑Electric Electric Main Breaker Size (Residential only) 1:1150 Amp or Less ❑ 200 Amp ❑Other
Contact Name & Phone # of JOBSITE SUPERVISOR: 8\ y 1"oc ht fn Q -720 709 -7
Electrical r,kjj���4f U1I54- Mechanical
Framer J Roofing
Concrete
Plumbing
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 City of Fort Collins ordinances and state laws regulating building construction. f I
Applicant Signature - Print Name �#A1lill &QC 14,4L Phone i��pt C f 7{o
d
Distribution: White - Office Yellow -Applicant Pink - W WIN/Stormwater
THIS APPLICATION EXPIRES 180 BAYS FROM APPLICATION DATE