HomeMy WebLinkAbout820 SNOWY PLAIN RD - APPLICATIONS - 6/29/2012City of
F� rort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. a Fort Collins, CO 80522-0580 a Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER�APPLICATION DATE
Job Site Add
Unit #
PROPERTY OWNER
` cY�U) CINFO: (All owner
'information is required - it is not optional) Phone #
Last name G�vn-ylfelI — First Name Middle
Street
CONTRACTOR INFO: Company Name s
s�bo
Lic Holder Name
City f�r O�\� `� State CC' Zip �DS ZZ
Contractor Phone #
City of Fort Collins License # Supervisor Cert #,
Mailing Address City State Zip
GAL INFO:
Su division/PUD Filing # Lot # Block # Lot Sq Ft
C '4STRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Res ential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
15' Floor Sq Ft
Finished Bsmt Sq Ft
20d Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
# 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 #
(TIES INFO:
List appropriate option
Wa r 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: `ice i w
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: +
Electrical C_l) s Mechanical btx1r.1✓1 Plumbing
Framer Roofing Concrete Fireplace
Solar Other Other Other
Applicant: I hereby acknowledge that Ave read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort oll' s ordinances and state laws regulating building cc truction. �/ �/ / �{
Applicant Signature Print Name �GA 4� Phoney'TbS3-✓L
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THI APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE