HomeMy WebLinkAbout932 E PITKIN ST - APPLICATIONS - 1/25/2013City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins, 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221.6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION A,,,c.F4
APPLICATION NUMBER 5 / 5 APPLICATION DATE
)QJob Site Address ��J2 E . Pii kl n Unit # �/ l
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # QP —
t,�r �
Last name o' {� j� First Name � jY �i�-Y t �4e- Middle C,
Street Address q 2 L• C 1 �K.,l 8 � City � �oll -A S State C� 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'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft 2nd Floor Sq Ft 31 Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/< Baths '/z 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) $ \ 17007
I j
)(Description of Work: 1 eA CA u-St-L - CifL be_C%-V1q be+WCE-n K4Af_n
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
'+offFFort Collins ordinances amend state laws regulating building construction.
Applicant Signature ` , l b ` Y Print Name Q-st__. Eyck 1n Phone
Distribution: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLOCATOOM EXPIRES 180 DAYS FROM APPLICATOOR DATE