HomeMy WebLinkAbout3460 S College Ave - Applications/Other - 01/03/2018City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6r Collins 281 N. College Ave. • Fort Collins. CO 80524 • Phone: 970-416-2740
www.fcgovcomlbullding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER "I APPLICATION DATE { ✓'
Job Site Address Lr7 z_-,,::> I L:il r-, Unit #
PROPERTYOWNERINFO: (Alt oowner information is required— it is not optional) Phone # ��Y�cri • 22��
Last name 0-2 / /�Fiirrst Name Middle
Street Address 471 I �i �1� —'! City ' le-,6, State�Zip
CONTRACTOR INFO: Company Name%�Y7 Contractor Phone #
Lic Holder Name
Mailing Addres
LEGAL INFO:
:. _I:_ �r1JCJYtA
City of Fort Collins License # Supervisor Cart #
_ City. State Zip
Filing # +f Loot # Block # Lott Sq Ft
ent l� Total Garagsaq
Residentia6 Ft Comm'I Sq Ft # of Stories Bldg Height Iling Units
1" Floor Sq Ft 2nd Floor S Ft Fi q0t Unfiished Bsmt Sq Ft _
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths ' the # of Fireplaces
Air Conditioning: YerN y n propna c oc ❑ 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door 4. Si erformance Alternativer 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
Water Tap Size es Temp. Pedestal Yes❑ No❑
Type of Heat ElGas Electric c Main Breaker Size (Residential only) 1 ss ❑ 200 Amp Other
Value of Construction (including labor, material & profit) $ MO/
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
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 Fo llins ordinances and state laws regulating building construction. 1
Applicant Signature Print Name i /,y rr_> tc Phone
Distribution: White -Office Yellow —Applicant Pink -WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE