HomeMy WebLinkAbout2408 Moffett Dr - Applications/Accessory or Secondary Building - 02/07/2017 (2)City of II 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 ✓' T00 J t�)I -7ck JZJ APPLICATION DATE I r
Job Site Address agog- (qa t+C� �1 Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not oopttionn-al)� Phone # t l U-�P in" zZod
Last name T<*'Si> First Name Middle -1bb'Kj
Street Address 644yg— VIo RCA- bQ• City F - (�2LL4 (-s State CO Zip iRbSd1-(o
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Add
LEGAL INFO:
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
City
State Zip
Subdivision/PUD Filing # G Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) O� �Si Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height `7 ' iZ # Dwelling Units
1s' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes 0
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2"d Floor Sq Ft
3r1 Floor Sq Ft
# of Bedrooms # of Full Baths
% 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
Water Tap Size Sewer Tap Size
List appropriate option
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) $ ;2S'7-) X ;I _ 4S`ou
Description of Work: HwD Ge0-4U f�VsF—nS 1 3/ 1. 6AL VAOIZFO PLPE- /�v�p I N r0 C4eL*4D
R, wcxjj7 S STv-n_ paS7- C.,.r eli ,..t-r4 &&4l/
Contact Name & Phone # of JOBSITE SUPERVISOR:
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 Fort Collins ordinances and state laws regulating building construction.
Applicant Signature�� � Print Name cxQ� Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE