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HomeMy WebLinkAbout3801 Caribou Dr - Applications/Addition or Alteration - 09/15/2016City of F6rtCollins � COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER Y-� I APPLICATION DATE f 1 r (Q Job Site Address 3901 C Ar, 1 &-ou 0fL Unit # PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # L?% 0- & ,7 — C)%7 y Last name 5011 Ll Street Address '3901 aAa I gOv PR_ First Name Vv►A-rT Middle City F6nr LL/�vs CONTRACTOR INFO: Company Name O i- r-/M Contractor Phone #. Lic Holder Name City of Fort Collins License #, Mailing Address City. LEGAL INFO: State L' O Zip E-0 5- Z5- Supervisor Cert # State Zip Subdivision/PUD Filing # Lot # Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft Residential Sq Ft q00 Comm'] Sq Ft # of Stories Bldg Height # Dwelling Units I 1 S' Floor: Sq Ft 2nd Floor Sq Ft V Floor Sq Ft Unfiished Bsmt Sq Ft Finished bsmt Sq Ft # of Bedrooms # of Full Baths '/ Baths '/z Baths # of Fireplaces iAir Conditioning: Yes No Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing i 3. ResClieck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door City of Fort Collins Stock Plan # List appropriate option #s 'UTILITIES INFO: '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 & profit) $ - ,00 of Work: AD jQ I 'Wfa2Ljf�1M�X VO)TP®N OP 3 WPrLL.S;'T0 W-1-04 /.►TL'' lc"iiiJ✓!�'�1-a j7A'R120a-.-\, A-0v i IMt3v6- Y-1 TGF/ta'v Of - 5 w lz- RANbg ;.Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: C}VJN-.12 Electric al Mechanical Plumbing Framer Roofing Concrete Fireplace Solar Other Other Other Applicant: 11 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'Signature Print Name �� s al- Phone 970 917 ©0 0 i Distribution: White —Office Yellow —Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE