HomeMy WebLinkAbout2830 Bluegrass Dr - Applications/Solar - 06/03/2016®ey Jr
C` Oe
Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER ObI v 0C I APPLICATION DATE (U 3 A
Job Site Address 2�7-3G Bio greus Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Clio - '430 G �-
Last name cro �u r^ 1 First Name '��F Middle
Street Address 01 � f l (1! r" pi 3), City `�'�i� � j�� h� State Cd zip ;)-n.i7 l
CONTRACTOR INFO: Company Name Aj,,, ..zkL Contractor Phone # 3a3 ��`f7 -U�r3� K31
Lic Holder Name City of Fort Collins License # 5 -2 S9 Z. Supervisor Cert # 2�ff 7—' S
Mailing Address `� S7/ (, f 0'��`> �� City �a�1 State zip
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
.U�rFloor Sq Ft
Finished Bsmt Sq Ft
2"d Floor Sq Ft
Filing # Lot #,
Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3ro Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths 'Y2 Baths # of Fireplaces
Air Conditioning: Ye�]Non Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 11 6. Prescriptive w/ Blower Door[
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes ❑NoF] Temp. Pedestal Yes❑ No ❑
Type of Heat: n Gas1-1 Electric Electric Main Breaker Size (Residential only) 1:1150 Amp or Less 11 200 Amp Other
Value of Construction (including labor, material & profit) $�
Description of Work: /S kuV vS 4 M.0v4 iUi1� 'P:EilYe_
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge that I havazead this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort I s ord' aces-a� state laws regulating building construction. / (�
Applicant Signaturi�i Print Name � �S v� t� l� Phone 3�3 Y�3 ' O? U o
Distribution: W ' e - Office Yellow -Applicant Pink - WWW/Stormwater
TWIG APp1 IP_Air nki FYPIQig4; 42n nAVC RRnm APPI If'Arinm nArp