HomeMy WebLinkAbout628 ENDICOTT ST - APPLICATIONS - 2/1/2012city of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER IJ' �yyS Iy APPLICATION DATE
Job Site Address DIC.oT-r ST fr c,a4tVs5 Unit #
80524 q 70 `i 9 6 - 151(o
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name ,lFinas First Name C 14e-Q Middle S
Street Address G,2�i3 EiJpz:l'orr sT City %r State C O Zip e0SZ4-
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Add
LEGAL INFO:
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
City State Zip
Subdivision/PUD SI I ZMr�►� is OVO-4 `lY*t�O Filing # Lot Block # 2 Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
1s' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
# of Stories
3rd Floor Sq Ft
Bldg Height # Dwelling Units
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/< 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
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) $ i60-0 '
Description of Work: C01vS-r9-Q C-T'To ►.I or A Gf:DA%e- -fTx^SGK ?FP b0e- h
13Gt*rt.,0 Woos,F , T146 STi2U(,TUfZC- J5 FREEST'RN�iN6
q ' - G r' V It(-" rt.j DDT -&A 0JSZDA/ . `( O SL.
Contact Name & Phone # of JOBSITE SUPERVISOR: CYNC- ► S r 9 SE ^ I'��i t'.e--i
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
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 City of Fort Collins ordinances and state laws regulating building construction. Applicant Signature Print Name 0-fifZ.n K-NTW-$ p Phone -70 OF) -)516
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE