HomeMy WebLinkAbout301 Peterson St - Applications/Addition or Alteration - 01/06/2017City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For+t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER I _7�c�C2(0_3 APPLICATION DATE I / ZI -7
Job Site Address �)(qI i)
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # / 70- t?Ro? - 6.2 Y I
Last name on S r JP First Name 4nd real Middle
Street Address 54 �., e- City
CONTRACTOR INFO: Company Name // N 1,44P
State Zip
Contractor Phone # Gl 70-213 -1902
Lic Holder Name Kt �e:t AddlA.h2r' City of Fort Collins License #C. 7. - 3 Supervisor Cert #
Mailing Address '73,5-5 6 reeh r:d se �oqo� City W : ndw K State CO Zip 80_�j Q
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm] Sq
16' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2ntl Floor Sq Ft
Filing #.
Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3rtl Floor Sq Ft
# of Bedrooms # of Full Baths 3/. Baths
Unfiished Bsmt Sq Ft _
/2 Baths # of Fireplaces
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
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) $ (9S arA2
Description of Work: k1 kr-'B/ S /C, f QPha b act i n eP/
Contact Name & Phone # of JOBSITE SUPERVISOR: 0ab m% 11 R 7B - 3Xj' / 7 q 6
Subcontractor Info:
Electrical
Framer Roofing
Solar 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 Fortollins ordinanoll and state laws regulating building construction. / a
Applicant Signature Print Name L e-6 M I W -el Phone O- 3p !- 1 )1y
Distribution: While —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE