HomeMy WebLinkAbout3281 GLACIER CREEK DR - APPLICATIONS - 2/14/2014City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. a Fort Collins, CO 80522-0580 • Phone: 970-221-6760
wvvw.fcgov.com/building / V 3 IV —,
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 5I e ®O 6 1 1� APPLICATION DATE (72 ^ l 1 i `%
Job Site Address 1/_,41611F2 C-Aif_ Unit #.
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone
Last name �Q (�%y COM1)1UN1/7(-S First Name Middle Street Address �LI Ci S SI^/�� 4 �-e- De City � D & Aiyr-2 state 6y zip 97 ZZ-S?
CONTRACTOR INFO:
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Company Name ' IS r t Ems/ " IE - Contractor Phone #
Lic Holder Name (iw�� �� ��-S City of Fort Collins License # Supervisor Cert #
Mailing Address A�gO-j - City.
LEGAL INFO:
State Zip
Subdivision/PUD • � tFiling # Lot # Block # Lo'
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) -Los Garage Sq
Comm'I Sq Ft # of Stories �" Bldg Height ( # Dwelli
Residential Sq Ft Z0 b
1s' Floor Sq Ft l 2nd Floor Sq Ft 3rd Floor Sq Ft Unfiished Bsmt Sq Ft �Ule T -
Finished Bsmt Sq Ft # of Bedrooms 3 # of Full Baths � '/< Baths '/z Baths I # of Fireplaces 1
Air Conditioning: Ye No Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door �Si lated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # y9 i q G3
UTILITIES INFO:
List appropriate option #s If Z it Lt . 1
Water Tap Size Sewer Tap Size Metered:62or No���� Temp. Pedesta(�or No
Type of Heat: 4 as ❑ Electric Electric Main Breaker Size (Residential only) 1150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ �r) LID
Description of Work: AJ12-W S' I `1) yq r - �'j
Contact Name & Phone # of JOBSITE SUPERVISOR: Ci-44 -� &j % o s 6 -V I �-( T
Subcontractor Info: (� 1 In
Electrical (' W ( Mechanical � � _ �� � j Plumbing x NN - tl t uyi • Sot,
Framer ��CP(tZ Roofing Concrete \ Concrete- �% IN Fireplace 7j--fT?4_L
Solar Other Other Other
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Applicant: I hereby acknowledge4ft i I r d thi application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fortl ollin rdiiL ce nd state laws regulating building construction.
Applicant Signature Print Name C�vl ` t Tt7 l�/ Phone
White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE