HomeMy WebLinkAbout5409 Apple Dr - Applications/Shed - 12/21/2016City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins 281 N. College Ave. - Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ `� www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 12> I1/b-1 APPLICATION DATE�T>yr' 2i • ZOI �.
Job Site Address S4611 #r ppl-e -Drive- Unit #
PROPERTY OWNER INFO: (All owner information is required - it Is not optional) Phone #
Last name -G3 u ( PC First Name c`7 c" a Middle l.J
Street Address 9vp e -0rI-oC- City (foillVIS State eO Zip 5015ZG.
CONTRACTOR INFO: Company Name SG ` l Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cart #
G.I
Mailing Address � 1)4f pdDple Dr City e+ • Cp[I 1 U 5 State (-O Zip &-A52--jr,
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft_
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 1 W Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
ls' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
# of Stories Bldg Height r 2 s # Dwelling Units
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/. Baths '/2 Baths # of Fireplaces
Energy into: ( 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 #s
Water Tap Size Sewer Tap Size Metered: Yes or <0 Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) Pj150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) S� t Doo
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledgt 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 F Collins ordin as s and state laws regulating building construction. 11
Applicant Signature Print Name 11L Wr' Phone Q%O 40t 53$5
n: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE