Loading...
HomeMy WebLinkAbout411 S BRYAN AVE - APPLICATIONS - 12/17/2012COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES Fort Collins APPLICATION Job Site 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 www.fcgov.com/bui Id ing BUILDING PERMIT APPLICATION co22w+ APPLICATION DATE 9 ^ I / ' I Z Unit # PROPERTY QWNER INFO: (All owner. formation is required - it is not optional) Phone # Last nam �l0 / /%�irst Name Middle Street Address d© 4o&lm i City j �QStag QpZip CONTRACTO INF - Company Name rll-%lS1 AZ— ! 6L.L61'(� Contractor Phone #j / —�✓ / 'r��� Lic Holder Name C7��/�c�� Y M1« City of Fort Collins License # Supervisor Cert # Mailing Address ,� / /6)' Ca' le �0 City L State � zip W (/2�) LEGAL INFO: Subdivision/PUD Filing # Lot # Block # Lot Sq 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 151 Floor Sq Ft Finished Bsmt Sq Ft 2nd Floor Sq Ft 3'd Floor Sq Ft Unfiished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/z Baths # of Fireplaces Air Conditioning: Yes 01 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: Water Tap Size Sewer Tap Size Type of Heat: ❑ Gas ❑ Electric Electric Main Value of Construction (including labor, material & profit) $--Z Description of Work: Az/y ri�GGGt Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: P//,( Electrical �� ���� Framer J"ff jjj, _4NZL-Aoofing _ Solar Other Mechanical List appropriate option Metered: Yes or No Temp. Pedestal Yes or No Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other - �d 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 ort Collins or an es and state laws regulating building construction. Applicant Signature ����1 T-_ Print Name Phone Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE