HomeMy WebLinkAbout901 EDWARDS ST - APPLICATIONS - 12/10/2012Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER I Zn12�3
Job Site Address
(AlVwner information is required —
Last
Street
CONTRACTOR INFO: Company Name
Lic Ho er ame
Mailing A ress
LEGAL INFO:
Subdivision/PUD
First
CO STR TION INFO: Total Building Sq Ft (not including
Resid ial Sq Ft Comm'I Sq Ft
1 s' FI or S t 2nd Floor Sq Ft
Finished Bsmt Sq Ft
Air nd'ioning: Yes No
3. Res heck w/Blower Door
City of Fort Collins Stock Plan #
APPLICATION
optional)
Unit #
one # —
Middle r _
_.� Statej��Zip -7=VL
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
City State Zip
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
31 Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/4 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
UTILITIES INFO:
WaXfHe
ize Sewer Tap Size
Typ: ❑ Gas ❑ Electric Electric Main Breaker
Value of Construction
of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical
Framer Roofing
Solar
Other
MI tered: Yes or No
sident!aLjw*)
0
l
Concrete
Other
Temp. Pedestal Yes or No
150 Amp or Less ❑ 200 Amp ❑ Othep
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge that I have read this appligation and state that the above information is correct and agree comply with all reguirements
contained herein ity efe s ordinan es and to I s regulating building construction.
e'
Applicant ignature Print Name Phone
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE