HomeMy WebLinkAbout3551 SWITCHBACK RD - APPLICATIONS - 1/23/2015Fort Collins
APPLICATION
Job Site Address
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
(� BUILDING PERMIT APPLICATION
O U1 ( APPLICATION DATE Oy.J - -
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Q-7 - ya l ' 1&1/y
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Last name Yt •Pa I�b'i �7Tbr. ame Middle
Street Address _q e hnyl r1.�1. �Idii /S CityjLi in��5di/ State °C�Zip
CONTRACTOR INFO: Company Name 4C)e , #Jckr -- �S_ Contractor Phone # 5 n 7 / - / 95/ Y
Lic Holder Name �1 a [pi � �f /. /City of Fort Collins License # L 6 f a9r Supervisor Cart #71/
Mailing Address 6&7 1�20NYIdl 4 4 T��/ 1/41 JCity U)j4 &01/' State�_Zip JS
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LEGAL INFO:
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Subdivision/PUD Fr` I 14 f'Ci Filing # C c� Lot SS.
# Lot Sq Ft/ o '
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) �J / SS. Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft ?e'�b S2"d Floor Sq Ft /v%T 31d Floor Sq Ft Unfiished Bsmt Sq Ft S .
Finished Bsmt Sq Ft # of Bedrooms, # of Full Baths ,4- 3K Baths '/z Baths J_ # of Fireplaces
Air Conditioning: Yes o Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
esCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # e0z List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size 7 Metere . Yes or No Temp. Pedestal Yes or No
Type of Heat: KGas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp [:]Other
Value of Construction (including labor, material & profit) $ ��I i
Subcontractor Info:
Electrical' t so_ ��1'[� L(. Mechaniical j__ Plumbing : NJ
Framer HC� u1k�iC1Y1`P Roofing TS Rckwct Concrete Fireplace 'jn
Solar (i4 6u -S Other `J Other 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 Ci f Fort Collins ordinances and st laws regulating building construction.
Applicant Signature VQ�' Print Name -(Skj Phoneq7)0, f03%'oA�
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE