HomeMy WebLinkAbout2420 Purdue Rd - Applications/Addition or Alteration - 08/17/201767 rt C F,ollins
APPLICATION
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fegay.com/bulldlng
BUILDING PERMIT APPLICATION
APPLICATION
Job Site Addresses `/-2 Q f Uk D U E AD Unit #
PROPERTY OWNER INFO: (All owner Information Is required - It Is not optional) Phone #
Last name De/4K hU ff First Name /Qo l3 eRT Middle
a;
Street Address ,e10O P U R DUE R. 17 CItyF0 27' C O (. C r nS State CO Zip S 0 SX S"
CONTRACTOR INFO Company Name
Contractor Phone
Lie Holder Name City of Fort Collins License # Supervisor Cart #
Mailing Address City State Zip
LEGAL INFO,
Subdivision/PUD S DUTht C O L I- f9 a 14e i Punfhlmg # Lot # :Z 1 Block # S Lot Sq Ft 8 o 5-8
CONSTRUCTION INFO. Total Building Sq Ft (not including basement) 1 O S3 Total Garage Sq Ft e?T 7
Residential Sq Ft
1° Floor Sq
Finished Bsmt Sq Ft
Comm9 So Ft # of Stories Bldg Height # Dwelling Units
2i° Floor Sq Ft
3^' Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths _ % Baths '% Baths _ # of Fireplaces
Air Conditioning Ye o 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 11 6 Prescriptive w/ Blower Doom
City of Fort Collins Stock Plan #
List appropnate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered Yes ❑No❑ Temp Pedestal Yes❑ No ❑
Type of Heat ❑ Gas OEletRnc Electric Main Breaker Size (Residential only) ' EZ]150 Amp or Less1:1 200 Amp []Other
00
Value of Construction (including labor, material & profit) $ �G 7,570
Description of Work Rc,-daoPe_L KrTct4eA 04 GRAge- LLEcT PAA.)t_L / /iDa�✓.
FiANfL 7 F/(Lfrf DJTS/O< G✓'FCCS L� 134e"r
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor info:
Electrical7X GiTV &_&CT Mechanical
Framer
Solar
Roofing
Other
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 Cdy rt C ordinances and state laws regulating building construction
Applicant Signature �"� Pnnt Name Aped k / N Phone q10 1// 2
rd �®�mwatar aols.
Distribution White -Office Yellow -Applicant Pink -WWW/Sormwater
THIS APPLICATION EXPIRES 160 DAYS FROM APPLICAT16N DATE