HomeMy WebLinkAbout901 EDWARDS ST - APPLICATIONS - 10/19/2015COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.comlbuilding
APPLICATION NUMBER
Job Site Address
BUILDING PERMIT APPLICATION
APPLICATION
Unit #
PROPERTY OWNER IN O (All w er information is required —� no tional) Phone #
Last name First Name a Middle
Street Address // City i / State��ZipS
y
CONTRACTOR INFO: Company Name Contractor Phone # ,
Lic Holder Name
Mailing
City of Fort Collins License # ,� Supervisor Cert #
Zip
LEGAL INFO:
Subdivision/PUD 22� cS�Filing # Lot # l Block # Lot Sq Ft-0./-
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) ) 3 29r =-Q4- Total Garage Sq Ft
Residential Sq Ft.-a/026L/omm'I Sq Ft # of Stories Bldg Height #Dwelling Units
1s' Floor Sq Ft 2nd Floor Sq Ft / 3rd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/< Baths Yz Baths # of Fireplaces
Air Conditioning: Yes Flo 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 #
List appropriate option #s
UTILITIES INFO: // /O ,✓ F i /-t'
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 I,nff
Electrical
Mechanical,
Framer AZ ofing
Concrete
Solar Other
Other
//i G-e�- / i
WAN IN
INS
Plumbing /U
Fireplace-- I
Other D
Applicant: I hereby acknowledge that I have read this application an slat at the above information is correct and agree t co ply with all re uirements
contained herein =ans orcfi es and st to law re ling building construction. Applicant SignaPrint Name f !/ hone L Y
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE