HomeMy WebLinkAbout1104 Beech St - Applications/Addition or Alteration - 04/20/2018City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rt Collins 281 N College Ave • Fort Collins, CO 80522-0580 • Phone 970-221-6760
www fcgov corn/budding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER �T� 13 APPLICATION DATE Za I
Job Site Address
(All
Last name Y
Street Address
CONTRACTOR INFO Company Name
Lic Holder Name
Mailing Address
LEGALINFO
Unit # 14
information is required - it is Wt optional) Phone # q-7D �-J'6 -
� � First Name54 Middle
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'QL�C�( City � -$tate Lj Zip
Contractor Phoneit
KM -
of ro- t Collins License #
City.
State
Supervisor Cert #.
Zip,
E
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft r
CONSTRUCTION INFO Total Budding Sq Ft (not including basement) D Total ar�age Sq Ft
n'3
Residential Sq Ft ' ' Comm I Sq Ft # of Stor
ies BI g Height # Melling Units
15' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning & No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO
2nd Floor Sq Ft
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/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
List appropriate option #s
Water Tap Size
�/ Sewer Tap Size Metered ]9 or
Type of Heat y Gas ❑ Electric Electric Main Breaker Size (Residential only)
Value of Constructio
Description of Work
No Temp Pedestal Yes or
❑ 150 Amp or Less ,k200 Amp ❑ Other
Contact Name & Phone # of JOBSITE SUPERVISOR
Subcontractor Info
Electncal D MechanicaiNAAV Plumbing
V fm —
Framer Roofing Concrete Fireplace
Solar
Other
Other
Other
Applicant I hereby acknowled a hat I h ve re t is application and state that the above information is correc and agree to comply with all requirements
contained herein and City of rt Ilms rdm c and state laws regulating building co truction
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Applicant Signature Print Name �v W Phone V
Distribution White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE