HomeMy WebLinkAbout418 TOWHEE ST - APPLICATIONS - 3/17/2017COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES '
Fort Collins
APPLICATION
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
PERMIT APPLICATION
APPLICATION DATE 5� " I i — Iq
Job Site Addressi �/$ haw �22 -�><Go//r�r c� �osc�Unit #
PROPERTY OWNER_ INFO: (All owner information is required - It I��ss/ not optional) Phone #
Last name t Lo b r / First Name l�L't r f !S Middle
Street Address / City rmr11" ��/1rlf StateZip j�S0J26
CONTRACTOR INFO:, Company Name Sf F. Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City
LEGAL INFO:
Subdivision/PUD Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
State Zip
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft 12C2 Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
11
15t Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2ntl Floor Sq Ft
3" Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/< Baths /z Baths # of Fireplaces
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
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 Constr iction_(including labor, material & profit)
Description of Work: e-
Contact Name & Phone # of JOBSITE SUPERVISOR:
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 Fort Collins ordinances and state regulating building construction.
Applicant Signature ! Print Name kuo- %rj P. 1AGtdvr Phone q}U-30fl 6681
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE