HomeMy WebLinkAbout516 S. WHITCOMB ST., EXTRA OCCUPANCY RENTAL - BASIC DEVELOPMENT REVIEW - BDR180030 - SUBMITTAL DOCUMENTS - ROUND 1 -COMMUNITY DevelOpMeNT & NeIGHBORHOOD SeRvICeS
THIS ApplICATION eXpIReS 180 DAYS FROM ApplICATION DATe
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
APPLICATION NUMBER__________________________________________ APPLICATION DATE________________________________________
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #_____________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: ____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #__________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_________________________________
Last name________________________________ First Name_____________________________ Middle ____________________
Street Address__________________________________________ City___________________________ State________Zip______
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #_______________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #_____
Mailing Address________________________________________ City____________________ State____________ Zip_________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units _____
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces ___
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blowe
City of Fort Collins Stock Plan # _____________________ List appropriate option #s____________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $____________________________________________________________
Description of Work:_________________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: ______________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing _____________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _______________
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 requirem
contained herein and City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone ___________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip___________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #____________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip_______________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $_________________________________________________________________
Description of Work:_____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: ____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone _________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
APPLICATION NUMBER______________________________________ APPLICATION
DATE_____________________________________________
Job Site Address_________________________________________ Unit #______________________
PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________
Last name________________________________ First Name_____________________________ Middle __________________________
Street Address__________________________________________ City___________________________ State________Zip____________
CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________
Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________
Mailing Address________________________________________ City____________________ State____________ Zip________________
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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________
1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________
Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # _____________________ List appropriate option #s__________________________________________
UTILITIES INFO:
Water Tap Size ___________ Sewer Tap Size ___________ Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 150 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $__________________________________________________________________
Description of Work:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________
Subcontractor Info:
Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________
Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________
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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature___________________________________ Print Name___________________________ Phone __________________
Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater
1st Floor Sq Ft _______________ 2nd Floor Sq Ft _______________ 3rd Floor Sq Ft _______________ Unfiished Bsmt Sq Ft ______________