HomeMy WebLinkAbout1016 Sunset Ave - Applications/Deck - 12/13/2016City of COMMUNITY 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 �IY�C/ I APPLICATION DATE
Job Site Address I O I L, ) vv s*kr A"t
Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #
Last name I-ArrtL` r-3~r" naaL I(SIN" c(c First Name Middle
Street Address f?RI F_ in.a�oi a S- �' D3Cf City Ft- CO( (� -r State QD Zip Y�OSa`t
CONTRACTOR INFO: Company Name (lC (-01'�014tM Contractor Phone# 9-7O 391 Ypq-7
Lic Holder Name Q A Nr/ qrn AMID t City of Fort Collins License # D - ` 40 Supervisor Cert# I7 a7
Mailing Address �i`lo-1 QVN MA- City FT C-01LQ-' 5 State C.O Zip ISOSPIJ
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'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/, 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) $ 6� S 00
Description of Work: (tf Inc 4 p 1 C'M . /U' fl'/AA OF Ff7V Si
Contact Name & Phone # of JOBSITE SUPERVISOR: Rw tp-/ Loot owr— Q 1 O 39 1 LI)
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 of Fort ": n ce state laws regulating building construction. 37
Applicant Signatur Print Name �r+ht5 Mne�i°v4`` r Phoned
l S 8
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE