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WHITCOMB ST., EXTRA OCCUPANCY RENTAL - BASIC DEVELOPMENT REVIEW - BDR180030 - SUBMITTAL DOCUMENTS - ROUND 1 -COMMUNITY DevelOpMeNT & NeIGHBORHOOD SeRvICeS THIS ApplICATION eXpIReS 180 DAYS FROM ApplICATION DATe APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740 www.fcgov.com/building APPLICATION NUMBER__________________________________________ APPLICATION DATE________________________________________ APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #_____________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #__________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_________________________________ Last name________________________________ First Name_____________________________ Middle ____________________ Street Address__________________________________________ City___________________________ State________Zip______ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #_______________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #_____ Mailing Address________________________________________ City____________________ State____________ Zip_________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_______ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft __________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units _____ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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/ Blowe City of Fort Collins Stock Plan # _____________________ List appropriate option #s____________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing _____________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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 requirem contained herein and City of Fort Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone ___________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip___________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #____________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip_______________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone _________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: Subdivision/PUD__________________________________ Filing #__________ Lot #________ Block #_______ Lot Sq Ft_____________ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)__________________________ Total Garage Sq Ft ________________ Residential Sq Ft __________ Comm’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ 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___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater 1st Floor Sq Ft _______________ 2nd Floor Sq Ft _______________ 3rd Floor Sq Ft _______________ Unfiished Bsmt Sq Ft ______________