HomeMy WebLinkAbout4719 MCGRAW CIR - APPLICATIONS - 6/17/2013City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rt Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER_ � l J U A,�"0 APPLICATION DATE / n/ I
Job Site Address !/11 9 /fit e,464w Lt(!�L!'.L� Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # q�jo — 9-g`6 Last name 64— First Name 'ti� Middle L .
Street Address q-1 19 M [_fib^-' (:!/i • City e�- ECG 1-os State 6D Zip (Zc!;�I6
CONTRACTOR INFO: Company Name
Lie Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
15' Floor Sq Ft
2nd Floor Sq Ft
Contractor Phone #
City of Fort Collins License # Supervisor Cart #
City
Filing #
Lot #
State Zi
Block # Lot Sq
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/. 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 #
UTILITIES INFO:
List appropriate option
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) $ Q'% qd 6
of
LAI
IN1S4
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical G Mechanical A�� �'' 'ri Plumbing T
Framer 6A44-*-'Z& 04Y5'r Roofing �-)t/l Concrete t- Ina Fireplace N` "
Solar /y A 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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature Print Name TJ:;F &4A4*-- Phone 9-ro ` ` ? -7 qK3
Distribution: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE