HomeMy WebLinkAbout912 PIONEER AVE - APPLICATIONS - 3/13/2009BUILDINC PERMITS & INSPECTIONS DIVISION4
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i / PO Box 580 • Fort Collins, CO 80522 0580 Phone 221 6760 /
www fcgov com/building l/
CityofFort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 01 4AQ APPLICATION DATE J 0 -6 q
'Job Site Address q1 Z P 1 o KP_ef 4 de Unit # / / //
ROPERTY OWNER INFO (All own1eJr information is required - it is not optional) Phone # q 7 6 6 7— � 6 � S-
Last Name !� P_ � r� m Th// }}�� First' Name p� o �1/ Middle �//��
Street Address _� %S^ `S t7 GN T t 'R✓i O� City hOy pi State 1. D 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 #_
CONSTRUCTION INFO Total Building Sq Ft (not including basement)
Block # Lot Sq Ft
Total Garage Sq Ft
r
Residential Sq Ft C 2.Fj Comm I Sq Ft _ # of Stories Bldg Height = / (o # Dwelling Units
1st Floor Sq Ft %L Z2n" Floor Sq Ft — Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms L # of Full Baths ' 3/, Baths _ Yz Baths # of Fireplaces
Air Conditioning Yes <No Energy info (Circle appropriate choice) 1 ComCheck 2 ResCheck w/Air Sealing
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO
4 E Star w/Blower Door 5 Prescriptive w/Au Sealing 6 Prescriptive w/Blower Door
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) $_
ADescnption of Work -rQ K t 2 Je t 14, Q
Contact Name & Phone # of JOBSITE SUPERVISOR _
subcontractor Info 'I
Electricala.h t ``/ Mechanical
Plumbing
Framer Roofing Concrete 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 la s regulating building
construction C� q / G
4pplicant Signatur rant Namely D t eS7 Phone t 70-4Z ? Ib !-
Distribution While - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE