HomeMy WebLinkAbout618 HOLYOKE CT - APPLICATIONS - 5/3/2011FCityof COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
6rt Collins 281 N. College,Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760
a wvvw.fcgov.com/building i
BUILDING PERMIT APPLICATION
APPLICATION NUMBER l D l /I,It1 APPLICATION DATE
Job Site Address 10 tie [v O)Le- LT Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # k&cg, D�pC �- +, 303 - 0820 20 '�'
Last name- ycne. ` First Name 1U b-C V +I Middle
StreetAddress D It e- t' C City c-\- (folk r; �t, State Le Zip
CONTRACTOR INFO: Company Name("-01P-%'— &AA4 — v�� Contractor Phone # Q ?D - 4QZ -(2<yA
nn
Lic Holder Name //Reece, t'"f//.k,' City of Fort Collins License # \ 69� Supervisor Cert # 0a - 1
Mailing Address b 312 Rucb&,,,A u $ i" City State Co Zip qCr.3 4/
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft
15t Floor Sq Ft
Finished Bsmt Sq Ft
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/2 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) $
Description of Work: Pig; 1 ` 3 e iL
Contact Name & Phone # of JOBSITE SUPERVISOR:7�K
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Plumbing
Fireplace
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 conss;'�trruction.
Applicant Signature Print Name ` 0 Y I S f-i 4 S Phone %?b
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE