HomeMy WebLinkAbout1916 Sequoia St - Applications/Solar - 06/03/2016City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1 QC? q �a APPLICATION DATE to
Job Site Address 0161 ` c vo i A Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ( Ly ~ v l -7fq 1�
Last name �fh f 0� First Name 2"2Y Middle
StreetAddressT �fi Se�lUO�`�i SJJ� )) / city ;'/� Cllki State �s� zip
A CONTRACTOR INFO: Company Name -alAIR"k �rlti� Contractor Phone # TG'5'- —0 3 CW X� t/6
Lic Holder Name
City of Fort Collins License # 5 -Z59 Z Supervisor Cert # 3 tY'I/ ` S
Mailing Address �/57/ Br7A61 t'-"Y S1 city �s�j.fi� State CA -zip ���
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft
151 Floor Sq Ft
Comm'I Sq
2nd Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths Y2 Baths # of Fireplaces
Air Conditioning: Ye�]Non Energy info: ( Circle appropriate choice ) 1. ComCheck11 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing F1 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
Eqter Tap Size Sewer Tap Size Metered: Yes [--]No[] Temp. Pedestal Yes[] No ❑
Electric Electric Main Breaker Size (Residential only) �150 Amp or Less 200 Amp Other
Type of Heat: a Gas
Value of Construction (including labor, material & profit) $ r
Description of Work: G/, / F(v54 &oro //k-Bcnf l �y Sis'� �� 7�eZ
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
.8_2F.trical
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 ordinances and state laws regulating building construction.
Applicant Signat�� - - Print Nameyy `/ ` �l [J �its-�w Phone
Distribution: White -Office Yellow -Applicant Pink -WWW/Stormwater
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