HomeMy WebLinkAbout712 Shadowmere Ct - Applications/Deck - 06/21/2017City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
�t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1 -1 C) 33 5J APPLICATION DATE a I ( I
Job Site Address 7I
Unit #
PROPERTY OWNER INFO:
INFO: (All owner information is required - it is not optional) Phone #(/ 7U) r�3 //�^ e�3
i�I
Last name I/ anVe x- First Name t C- Middle c"6
Street Address F, Q . j3C2 a a CitWa.�-,oh V ) Clz7 State C I zip
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address
Fe
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
City State
LEGAL INFO: ��II
Subdivision/PUD�(P1T� ` DIA�iibPJh(�S Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
1 s' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3r° Floor Sq Ft
# of Bedrooms # of Full Baths
% Baths
Unfiished Bsmt Sq Ft _
/z 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 0 Q0
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
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 ;rtC I in nances an ate s regulating building construction. �i
Applicant Signature Print Name �c % �'i`�i ��l��1 P t� Phon/'I 7�
/ Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater VC:��
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE