HomeMy WebLinkAbout2100 Dover Dr - Applications/Plumbing - 08/07/2018City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
/ www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
Job Site Address ;;l-tovUnit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # — ;1-4 `t
Last name (V-a,1A.)fl t k First Name Middle
Street Address `ak &-'-7,1 r �t`�yi City 'nc-k Cokk�r.s State eo zip $05;-b
CONTRACTOR INFO: Company Name M<- Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cart #
Mailing Address I k A0,7 Hokkm-.) City Fr Adtc�ac State CO zip —6a51to
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1" Floor Sq Ft
20d Floor Sq Ft
3°' Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/s Baths # of Fireplaces
Air Conditioning: YerNou Energy info: ( Circle appropriate choice ) 1. ComCheck ❑ 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door 4. Simulated Performance Alternative S. Prescriptive w/Air Sealing 1� 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes RNoR Temp. Pedestal Yes❑ No
Type of Heat: a Gas ❑Electric Electric Main Breaker Size (Residential only) 1:1150 Amp or Less ❑ 200 Amp DOther
Value of Construction (including labor, material & profit)
Description of Work: C,, �� iPJfi 1 �� �� 4e. - ),Ae
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
Fireplace
Solar Other Other Other
Applicant: I hereby acknowledge that I have read this appl�n and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins ord'narmRs an state -laws -regulating building construction.
Applicant Signature Print Name 'J:_��reA t)`W 4:Z_ Phone
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE