HomeMy WebLinkAbout4512 GOSHAWK DR - APPLICATIONS - 8/2/2016F6rt
CityofIICOMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Collins 281 N. College Ave. a Fort Collins, CO 80522-0580 a Phone: 970-221-6760
www.fcgov corn/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER �/ APPLICATION DATE q�(
Job Site Address ' 619— (a S���G r . , -�i� Co�� i�►aS Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ".1 -7D — �tg [ r ID (D
Last name Al lem First Name Middle / -
Street Address�2�k� �tr City Y State (,Q Zip goF2.W
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION ��IyyNFFO::T,,o��tal Building Sq Ft (not including
Residential Sq Ft P;Vk D►�i' Co m'I Sq Ft
1s' Floor Sq Ft �� 2n Floor Sq Ft
City of Fort Collins License #.
City State_
Filing # Lot # Block #.
Supervisor Cert #,
Zip
Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths % 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) $ e5q 0 E • TO
Description of Work: IQ" X 2!2 \ Q-14::,2 d t' cL of -e- LOL cot 31 S4-rt� + % t (�4A-9,
r
Contact Name & Phone # of JOBSITE SUPERVISOR: ,, e+f -uA I -\ I I-.Yb . G'1 D - Ll K [ -
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
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 FortCollins ordinances and state laws regulating building construction.
Applicant Signature Print Name 744 r o%i A 16 Phone
Distribution: White - Office Yellow - Applicant Pink -WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE