HomeMy WebLinkAbout700 E Drake Rd - Applications/Deck - 01/30/2017 (2)City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.cowWbuilding
BUILDING PERMIT APPLICATION
APPLICATION NUMBERB. 1I � rN1 C t II-�J� �g u � APPLICATION DATE
Job Site Address 00 6 - Unit # R%5
PROPERTY `OWNER INFO: (All owner information, is required - it is not optional) APlhone # � 1 D q � I � �20 ,5Z-)
Last name J V-K- � I C ✓i 6�GI' ir�tT't,"1ame iNj ) -4) / I ,, Middle _ I '-1 Q
I �]ID�Q �d� 1 SVI (/12. (� t 5 C ty Ul l CY lr2.t.sc_s State CAZip I�
Street Address /� �� �c�
CONTRACTOR IN: Company Name 0� L)M)'cf -)L,)Y' Contractor Phone #��r'_",�
Lic Holder Name �1 }r�Q . e City of Fort Collins License # �� ��Supervisor Cert #
Mailing Address �y 1 C� • DK��PP� City V- W 1 1� Stat
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1" Floor Sq Ft
21d Floor Sq Ft
3i0 Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/z 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
cSize (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material profit) T
�$ tri �g
Description of Work: F' Cp(,CAC'Q 'vkJOCA M ((`^0
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby ackno dg that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and Cit f Fort tins ordi antes d state laws regulating building struction. �Q
Applicant Signature Print Name PhoneQiD I t3 "�)D:�C)
stribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE