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HomeMy WebLinkAbout626 S GRANT AVE - APPLICATIONS - 5/22/2012COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER a�3c� �-3 APPLICATION DATE Job Site Address 6�Arr— 4 41�� Unit #, PROPERTY OWNER INFO: (All owner Information is required — it is not o—p/t�ional) Phone # � � � ©g-��, w1�i '4 Last name '4 j First Name Middle Street Address City State�ZipPDCO�? IF CONTRACTOR INFO: Company Name Contractor Phone Lic Holder Name / y of Fort Collins License # Supervisor Cart #� Mailing Address city l _ State Zip_ LEGAL INFO: Subdivision/PUD Filing # Lot # Block # Lot Sq CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units 151 Floor Sq Ft Finished Bsmt Sq Ft 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 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: 7_� zSs ttJ[ Z��9 L-Szc S.ti�4�ti Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical Framer Solar Roofing Other Mechanical Concrete Other Plumbing Fireplace Other Applicant: I hereby acknowledge at I have rea i lication and state that the above information is correct and agree to comply with all requirements contained herein and Cit tins ordinances and tate laws regulating building construction. Applicant Signature Print Name —Phone 3 39� Dist e —Office Yellow— Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE