HomeMy WebLinkAbout839 CAMPFIRE DR - APPLICATIONS - 5/28/2015City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort+t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER B 15 039-1 3 APPLICATION DATE 5 - ago - I s
Job Site Address ?)3gI Ycz Dr • Unit #.
PROPERTY OWNER INFO: (All owner information is required- it is not optional) Phone
Last name %�/%^'iS First Name 8n -ZA I: Middle
Street Address X. � Pl/�a� %Q City l=T• /OCL-/A-4-S• State_,6_Zip L` �T
CONTRACTOR INFO: Company NamQS/�O A) T uNfk(SF A) '� R-Lii - &ntractor Phone # 976 ' . ?017 • JSL I -
Lic Holder Name V C Y Fo/rt� Collins License # 3 /Supervisor Cent #
Mailing Address /�' y��/) i d= •C�' City �[L' e6L., �. State Ld Zip f4l.&J f
LEGAL INFO.
Subd
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
151 Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3rd 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 #
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:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: j
Electrical A-/ A
Framer
Solar
Roofing
Other
Mechanical ti-/A
Concrete
Other
y
Plumbing N�A
Fireplace
Other
Applicant: I hereby acknovtledge that 1 have re ation and state that the above information is correct and agree to comply with all requirements
contained herein and City f rt Collins or ' ances and sta laws regulating building construction. 0'70 - 3' ` 7Applicant Signature_ Print Name �iS /44-eJCJy&A)Sht�hone 7 J 9ZL j,
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE