HomeMy WebLinkAbout2743 Adobe Dr - Applications/Addition or Alteration - 02/09/2018City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 2A co Mq DS APPLICATION DATE
Job Site Address _A%� 3 Ao joc c1f 805Z5"_ Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name m d�eV First Name --& ^ jy't Lk.) Middle
Street Address M L[3 kWbe p ( City T+ l d11 1 AS State('o Zip
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Add
LEGAL INFO:
Contractor Phone #
City of Fort Collins License #.
Supervisor Cert #
State Zip
Subdivision/PUD M r°0.QQt. 5 dF._ S } Filing # Lot #_L6__ Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) =1gS::9-- Q 8 Total Garage Sq Ft - -4ca—
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
15' Floor Sq Ft - � 2nd Floor Sq Ft � Ba' 3rd Floor Sq Fj_ Unfiished Bsmt Sq Ft NI
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths Q, -/< Baths - /3 Baths — # of Fireplaces
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
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
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered<re.-I)or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas M Electric Electric Main Breaker Size (Residential only) 3d150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ ' I r asa
of Work: r0P '1iy 0A q G,f eg-e A'Ad hold Mokst -i 4 a.)lte
tin+t.I^^, nb�„-e ram ov_ 4 _rAe•t-al) nr-uj rod .,
Contact Name &Phone # of JOBSITE SUPERVISOR: JEw C V P/ l % 0 33 G 72S
Subcontractor Info:
Electrical - 9.1
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing -FBA-
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 ollins ordinances nse laws regulating building construction. Q> q /
Applicant Signatur Print Name /'•h /rc ✓ r% ckrf Phone _A-U)- U7ZJ
Distribution: White —Office Yellow— Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE