HomeMy WebLinkAbout4306 NEW BEDFORD DR - APPLICATIONS - 3/2/2016F&tCoftins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
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BUILDING PERMIT APPLICATION
APPLICATION NUMBER 4-� � � � I �D APPLICATION DATE V z
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Job Site Address
Unit #
PROPERTY OWNER INFO: (All owner information is required - it isis�not /optional) Phone #\ ` t -10 1 L. ,�Qf �7 _
Last name ii r First Name :�,yV ► •l W► ' `0l _ Middle AmnC6&Mc�� �J
Street Address��L t lQ! � 7C=CJ\��i�� r�� City, 4a'� Gc���i(1� State Zip CJ�J�JL.S
CONTRACTOR INFO: Company Name �� NQ��\.% C LAC, Contractor Phhone # -1 lQ s � V 112 7
Lic Holder Name �1 v` City of Fort Collins License # �C� Supervisor Cert # /0 -/.
Mailing Address XN GV City C(B2 —State_CC Zip '30 C7
LEGAL INFO: AA ll
Subdivision/PUDCCA0J C2f\ �=Qk6z&iling # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 1500 Total Garage Sq Ft
Kr< krm
Residential Sq Ft 1 5-0 Comm'I Sq Ft # of Stories_ Bldg Height # Dwelling Units
Is' Floor Sq Ft
2"d Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths Y2 Baths # of Fireplaces
Air Conditioning: Ye ON Energy info:( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing ❑
3. ResCheck w/Blower Door E
4. Simulated Performance Altemative❑ 5. Prescriptive w/Air Sealing S. Prescriptive w/ Blower Door[
City of Fort Collins Stock Plan #
List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes [IN oF] Temp. Pedestal Yes No
Type of Heat: ❑Gas [-]Electric Electric Main Breaker Size (Residential only) ❑l50 Amp or Less 11200 Amp ❑Other
Value of Construction (including labor, material & profit)
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR: 'F- crsk d 2, Q- ` 0n z i % ogt
Subcontractor Info: AeCA-
ElectricalGV,Ac1\ Q\ec\�w\cQt\Mechanical - ►� Plumbingl'L� `�G��✓\ &(A
Framer
Solar
Roofing
Other
Concrete
Other
Fireplace
Other
Applicant: I hereby acknowledge that I have lead this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins ordina ces and state laws regulating building construction. ►.,
Applicant Signature Print Name �Irt e%Z1e` d
Phone f70r3jj"t((2
Distribution: White — Office Yellow— Applicant Pink — WWVV/Stormwater