HomeMy WebLinkAbout930 WHALERS WAY - APPLICATIONS - 9/14/2015City of I I COMMUNITY 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 [::5 (-0 / --0y APPLICATION DATE
t� I I
Job Site Address G3o U)A19VrQ5 WAS/ Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ^/�
Last name Foe)%-'CK First Name A2>a> I: —:-Middle A
Street Address 50 WAAL&eS W �4,/ City GeT GOLl.lnls State GO Zip
CONTRACTOR INFO: Company Name sus &Wwee Contractor Phone #
Lic Holder Name
City of Fort Collins License #
Mailing Address City
Supervisor Cart #
State Zip
LEGAL INFO:
Subdivision/PUD I-bT I@&LAr1 or-ljkti%s Filing # Lot # '—iL Block # Lot Sq Ft
CONSTRUCTION INFO_ Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
151 Floor Sq Ft
2nd Floor Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished 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
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: 11 (1 ^^��
Electrical �j�CF Mechanical � I•tt7OLPlumbing NOC.d T4J,}Aeomcl
Framer G15ZA: Roofing :1WD6P&-0SyT Concrete CI P Fireplace
Solar
Other
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 City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature PddQZ:!D& Print Name JeE6E FtDE6116Q Phone .557 - 21,442_
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 160 DAYS FROM APPLICATION DATE