HomeMy WebLinkAbout900 S COLLEGE AVE - APPLICATIONS - 4/26/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER / /� J APPLICATION DATE
Job Site Address 900 CoheAe, voUnit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # / �0 rl� o 0 I y`
Last name D V i !\ CA Q�- First Name Middle 20 rG (3
I rn h i� City r (-. `- el l I, n S State Co zip0 Street Address Address - s 4�t e uAe'< ` 1
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
on ractorPhhone #
City of Fort Collins License # D
City
Filing # Lot #.
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm] Sq Ft # of Stories Bldg Height_
1s' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
3rd Floor Sq Ft
State
Supervisor Cert #.
Zip
Block # Lot Sq Fty
_ Total Garage Sq Ft 1 o C-) 0
# Dwelling Units
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/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 Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas lectric Electric Main Breaker Size (Residential only)50 Amp or Less ❑ 200 ApAp ❑Other
/(44
rr ��
Value of Construction including labor, m terial &profit) $ 2C� 0 _
Description of Work:
t.0 _ w..11
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical ) 1y e_- 1 i R� j1� )es..�'f�-Pd,�leechanical
Framer Gib ivy 1S`4� UQ'o�Sfing / e1� Concrete
Solar Other Other
Plumbing
Fireplace
Other
Applicant: I hereby ac n wledge that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and 't of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature Print Name \ Lev') Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM .APPLICATION DATE