HomeMy WebLinkAbout914 SYCAMORE ST - APPLICATIONS - 11/14/2013COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
APPLICATION NUMBER t/ 13 D S% 00
Job Site Add
BUILDING PERMIT APPLICATION
APPLICATION
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ! 70 — 41e>S --- yeg /
-r
Last name First Name Middle
Street Address ` S City _ State ep Zip
CONTRACTOR INFO: Company Name Contractor Phone # ZL6 334
� Lic Holder Namels� AtSGI-j City of Fort Collins License # Supervisor Cert#
Mailing Address 1�Z5^ /�[..�/ Z�%#� City 7—State e�c-::) Zip
LEGAL INFO
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
1 s' Floor Sq Ft
Finished Bsmt Sq Ft
2n1 Floor Sq Ft
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3rd Floor Sq Ft
Unfiished 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 #s
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) $ 14P o c--) —
Description of Work: l�`� cL j �4 S�5 r4jr.-4-r� c-.*,,
Contact Name & Phone # of JOBSITE SUPERVISOR: Q zl�
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge tilat I have read thi application and state that the above information is correct and agree to comply with all requirements
contained herein and s ordinances nd state laws regulating building construction.
Applicant Signature Print Name
White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE