HomeMy WebLinkAbout3150 Rock Creek Dr - Applications/New Commercial - 04/28/2016City 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
16 BUILDING PERMIT APPLICATION
APPLICATION NUMBER V �i . APPLICATION
Job Site Address 2) >L 0,VO'V-- 0,,-- Unit #.
PROPERTY OWNER INFO: (All owner information Lis required - it is not optional) Phone #
Last name V \�iA W1 nk 112-�G1a' l AFirst Name _ ^ ►� _ I Middle (�
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Street Address ���� S 1 A) �i � � Pro 0- City BU(A 1 (LV) d StateZip q gD
CONTRACTOR INFO: Company Name 2' ,P 1 n\4, M &n Contractor Phone # o1-10-2Z U77 - 6 9 151-/
Lic Holder Name o'j0!1 City of Fort Collins License # A- kDq Supervisor Certt #
Mailing Address 350g QTIl (A Il l �✓ tit City ��{ _ ��1 � ((1 5 State 7 Zip b ��
LEGAL INFO: � �1, 9LPo\Ao-00-pp3 _
Subdivision/PUD hq. bl kl�k' Sy Tb t0 Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) �� I LU � Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft-�)-jI LPZ L # of Stories Bldg Height Zbt but # Dwelling Units
161 Floor Sq Ft J Z i 2nd Floor Sq Ft 3rd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms 9LI # of Full Baths 4 -t 1/4 Baths '/2 Baths 6 # 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 7 Sewer Tap Size 10 Metered Yes or No Temp. Pedestal es r No
Type of Heat: VGas Elllee\ctt[cyri_cElectric Main Breaker Size ((Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material 8 profit)($ cT� �J , Cgi-1� • Db `�r� ,p I
Description of Work �� <,}yU e.71 7 Go c Ct 15� y mil) t { Y 1tVYI EYU l � �C�tLt l l� l )
Contact Name 8 Phone # of JOBSITE SUPERVISOR: t�1 A _ nzL tY1 s l �c Vj2
Subcontractor Info:
Electrical T43� Mechanical Plumbing
Framer Roofing -TV-->D Concrete :AZ� p Fireplace
Solar Other
Other Other
Applicant: I hereby acknowled a at I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and Cityot o ollins ordinances and state laws regulating building construction.
Applicant Sign' ature /' Print Name/walyp c L �,.J Phone �U�j Sy7 Z
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE