HomeMy WebLinkAbout438 HUDSON CT - APPLICATIONS - 10/4/2011City of 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 APPLICATION DATE
Job Site Address 413 9- AjL5,,, r-c rf Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name C� rP//�nc` First Name %n,'nradC Middley
Street Address -7 3 ti7 %iud5en City 4,.r-F State Co Zip fC,SZS
QG
CONTRACTOR INFO: Company Name /�orn nines �rr cr) , Contractor Phone # 1 7C `C2'cGf�
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
City of Fort Collins License #
State
Filing # Lot # Block #
Supervisor Cert #.
Zip.
Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
2"d Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft Z ff6 # 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 tt(Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ \tlV1�' 8o
Description of Work: -F—A yob \ CI YXO' U�st q �Pv v` 1 (,Si/` -� b
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical -;/ -ka C/0'n'flMechanical
Framer
Solar
Roofing
Other
Concrete
Other
Plumbing
Fireplace
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 CityofFort
��Collins ordinances and state laws regulating building construction.
Applicant Signature+.Gag--� ��i� '� Print Name Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE