HomeMy WebLinkAbout2106 Barnwood Ct - Applications/Addition or Alteration - 01/23/2017COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
APPLICATION NUMBER
Job Site Address d)- 16 l / -
PROPERTY OWNER INFO: (All owner information is required - it is not optional) /Phone # � � _ q, 0 �- `7 11 Lo
Last name, C First Name �� I C.�1�4t C Middle ' r
Street Address City dot-- Lo f ✓L 1 State Zip
BUILDING PERMIT APPLICATION
APPLICATION DATE
' I ;1--6
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing
LEGAL INFO:
Unit #
Contractor Phone #
City of Fort Collins License #.
City State,
Subdivision/PUD Filing #.
Supervisor Cert #
Zip
Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm] Sq
1 s' Floor Sq Ft
2"d Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished 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 #s
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) $ b I o� 0po
Description ofWork: "did a,_YAA4ynytA_ ,v A
L)
Ta JJ-vim/IM 6/1 � a-- '' 04.4-J_
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical YJ (I QM S �� C ( -Mechanical
Framer
Solar
Roofing
Other
Concrete
Other
Plumbing "t2m 1 U V11
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 Fo Collins ordinances and state laws regulating building construction. �l
Applicant Signature�,LGf� - - — Print Name Phone tf� 7 I 1(!
Distribution: White - Office Yellow -Applicant Pink - WWW/Storm er
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE