HomeMy WebLinkAbout3005 Tulane Dr - Applications/Addition or Alteration - 12/22/2017COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER h-� J v�vtAPPLICATION DATE L �� •'�
Job Site Address le. n P Unit #.
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 77 3 - 16 n `SS$s—
Last name (/,/ b 0) ,fj First Name )� i i Gt V\ Middle
Street Address 'DUOS
�>r- City For$
CvI
1;'nS
State (�C) Zip S
CONTRACTOR INFO: Company �
L� .S 1 c. Or'u^ L.LC
Contractor Phone #
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97D / I9 2-20 1
Name 11
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Lic Holder Name
City of Fort Collins
License # r'303
Supervisor Cert # FIZ
Mailing Address ��, E Pi k, A
Sfi City fo 0r`
(a t N 5 State
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CO Zip `oo �� T
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Filing # Lot # Block # Lot Sq Ft_
Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/4 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:
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 & profit) $
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Applicant: I hereby acki
contained herein and Ci
Applicant Signature_
Mechanical
Roofing Concrete
Other Other
Plumbing
Fireplace
Other
this application and state that the above information is correct and agree to comply with all requirements
=.s and state laws regulating building construction. fj
Print Name )Obi Vqti n )q& I I Phone r I U % o
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE