HomeMy WebLinkAbout2404 Brookwood Dr - Applications/Addition or Alteration - 08/16/2016City Of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER `1 0?'- APPLICATION DATE w I v
Job Site Address _'!)4j0 ra%(-I nos Or. Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # �/ I I - t?),51
Last name C �_e 0 4 FirstName t�lfl Ay-jjt1 cJScti ✓► Middle J
Street Address !70 �Jr oD F� w ou� idr_ City ---a 6'*o It j !n!5 StateClu , zip E&I
CONTRACTOR INFO: Company Name SfUr�/����v�G T. �D�(,$C-5 271nntractor Phone # g� 0 - � % - 9121
Lic Holder Name "rce; M /.Ze4- City of Fort Collins License # Supervisor Cert #
Mailing Address1� qaz Ac City ! , State zip A'95,2-5,
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 Comm'I Sq
1s' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3rd Floor Sq Ft
# of Bedrooms # of Full Baths 3/ Baths
Unfiished Bsmt Sq Ft _
'/2 Baths # of Fireplaces
Air Conditioning: Yes 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 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material n& profit) $ lT.�
Description of Work: K. TG&Gn 11A PA I 0 < A ✓IS aws 4 � 4t r co s 10 l
Contact Name & Phone # of JOBSITE SUPERVISOR: Fled,, e_c`1
cW foLy G
t, rcS a( A2 7 — W! 71 GG 5 14G.,5G T„y�
Subcontracctto/r Info:
Electrical / �1.� (i( /i rltGl �/r�Gl��c[, Mechanical = Plumbing��c✓ ��a,•w.lp���/
Framer Stretit—tli�• , Fn "Roofing Concrete Fireplace c
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 ��Collins ordinances and state laws regulating building construction.
Applicant Signature Print Name � Cr. in ae-r Phone X7— 071
Distribution: White —Office Yellow —Applicant Pink —WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE