HomeMy WebLinkAbout901 EDWARDS ST - APPLICATIONS - 9/19/2012City of
II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
�% ( GBUILDING PERMIT APPLICATION
90
APPLICATION NUMBER APPLICATION DATE — I ! I
Job Site Address Unit #
PROPERTY OWNE 1 FO: AI owner information is required -' s no ptional) Phone #
Last name First NaMiddle C /'-
Street Address City A 4u4Z5 Stato��—Zip3ni
CONTRACTOR INFO: Company Name Contractor Phone #
Lie Holder Name
City of Fort Collins License # Supervisor Cert #.
Mailing Address City State Zip.
LEGAL INFO:
Subdivision/PUD Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
1s' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
Block # Lot Sq
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/4 Baths /2 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 #
UTILITIES INFO:
List appropriate option #s
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 fitly) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
s-
Value of Construction (including labor, material & profit) $ '
Descriptioncl'�
of Work: t . n / //V0I'� 4- 1 /
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Mechanical
Roofing Concrete
Other Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge that I have read this applicatiop/and ate that the above information is correct and agree t comply with all requirements
contained herein a tjrofifort Cotli antes d stag g ating building construction. //
Applicant Sig a Print Nam // Phone —
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE