HomeMy WebLinkAbout5308 Fossil Ridge Dr - Applications/Deck - 08/29/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
City ®f
Fort Collins
281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER bl� n 504�-APPLICATION
Job Site Address fi.-3® � ,'l_�.P
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
I a.t name 0 r-k'�- First Name Middle
Zol
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Street Address ` �� � �- t2A4L Fes" City ` Z- State Cf-. zip 8 505
CONTRACTOR INFO: Company Name " t-L C PNC C-0^-5-5�\L+ Y-fcontractor Phone # 1 70 " ` Q-'el 8
Lic Holder Name V ll , x3e, Q.twt 4r4 City of Fort Collins License # 641't-&S-L- Supervisor Cert #
Mailing Address ?,Y---X L&S-01 City - (;J�tIwS��� State 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 Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
2nd Floor Sq Ft
3m Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/ Baths '/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:
Water Tap Size Sewer Tap Size
List appropriate option #s
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) $ -'i/ /Pj oco
Description of Work: ��T i��S/,tom q��2 LIL �i' �[E F2M-'9'21-� t4,%,t)
'7cslC �i op-rG1,46-t_ .
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Mechanical
Plumbing
Framer Roofing Concrete Fireplace
Solar Other Other Other
Applicant: I hereby acknowled that I ve read th' application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Ili ord' c nd state laws regulating building construction.
Applicant Signature e. Print Name /%r ,/� f� -I�A^J Phone 9;b W&�P-
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE