Loading...
HomeMy WebLinkAbout1104 Beech St - Applications/Addition or Alteration - 01/11/2018City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 / www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER �)1(96h21a-- APPLICATION DATE I I l-� Job Site Address PROPERTY OWNER INFO: Last n Street S owner information is required - it is CONTRACTOR INFO: Company Name Lic Holder Name Mailing Address_ LEGAL INFO: Unit# �j optional) Phone # 1 10 I ✓ �6-5 City Middle Contractor Phone # City of Fort Collins License # Supervisor Cert # City. State Zip Subdivision/PUD Filing # Q // Lot # Block # Lot Sq Ft �j CONSTRUCTION INFO: Total Building Sq Ft (not including basement)— {'� Total Garage Sq Ft Residential Sq Ft Comm'I Sq Ft 1s' Floor Sq Ft Finished Bsmt Sq-Ft Air Conditioning: es No 3. ResCheck w/Blower Door City of Fort Collins Stock Plan # 2od Floor Sq Ft # of Stories Bldg Height # Dwelling Units 3r1 Floor Sq Ft Unfiished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/s Baths /z Baths # of Fireplaces I 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 List appropriate option #s UTILITIES INFO: Water Tap Size % Sewer Tap Size — b� Metered: es r,-No Temp. Pedestal Yes or No Type of Heat: XGas ❑ Electric Electric Main Breaker Size'(Residen is oonly) 050 Amp or Less Value of Construction (including labor, material & profit) $ 1 1yD, ©60 1 -A Description of Work: W Mechanical / ng Concrete ❑ 200 Amp ❑ Other Solar Other Other 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 F rt qollin din nces and state laws regulating building con f�uction. Applicant Signature i�"6� Print Name �LY�f Phone Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE