HomeMy WebLinkAbout900 W PROSPECT RD - APPLICATIONS - 4/3/2013City of I COMMUNITY DEVELOPMENT S NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
. BUILDING PERMIT APPLICATION
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APPLICATION NUMBER \✓ 1 APPLICATION
Job Site Address `',( r) W, it • GDMI/V j C-u Unit #
PROPERTY OWNER INFO: (All owner information Is required - it is not optional) Phone # q7_ � �5
Last name
(��,First Name ��2/ /1 Middle �!/1
Street Address 900 W. po o w-.41 ± 0. City�`G'� (I> �/✓t� Stateo Zip
CONTRACTOR INFO: Company Name 1 it Qf�_ _ Contractor Phone #
Lic Holder Name
Mailing
City of Fort Collins License #.
Supervisor Cert #.
State Zip
LEGAL INFO: /n
Subdivision/PUD C_ Filing # Lot # Block # Lot Sq Ftoo� j
CONSTRUCTION INFO: Total Building q Ft (not including basement) Total Garage Sq Ft
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Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height1# Dwelling Units
1s' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
31d Floor Sq Ft
# of Bedrooms # of Full Baths % Baths
Unfiished Bsmt Sq Ft _
/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
Water Tap Size AIDAL— Sewer Tap Size WOW- Metered: Yes or 00 Temp. Pedestal Yes or No
Type of Heat: ❑ Gas F�Ellectric Electric Main Breaker Size (Residential only) 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (rnElu"ding labor, material 8 profit) $ lbot Re `- 14
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
/ f - CN23
1
Subcontractor Info: n A'
Electrical �/1 N Mechanical IVokke _. Plumbing /l &A. r
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Framer �iC 6L- Roofing /C 61- Concrete �(%Ytk� Fireplace
Solar
Other
Other
Other
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Applicant: I hereby acknowle a that 1 have reao this application and state that the above information., is correct and agree to comply with all requirements
contained herein and City of rt ,olliii�a ordina ces and state laws regulating building cons ction. , �% (�q j
Applicant Signature Print Name 2 *Ahone D 1 /GJ
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Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS . APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE