HomeMy WebLinkAbout618 COWAN ST - APPLICATIONS - 4/24/2017City of
I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. a Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER L./ M N� I ar APPLICATION DATE 41 a L� I r i
Job Site Address LQ I a l o�.og-ty ;:5t. rQ Unit #
PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone #
Last name Vt c k�?-4 First Name 30.so'c-N Middle
Street Address C91b 00�- 'N 'Sv. City �r% 0<A'r15 State co Zip FJL-y
CONTRACTOR INFO Company Name
Lic Holder Name
Mailing
LEGAL INFO
Contractor Phone
City of Fort Collins License # Supervisor Cert #,
City
Subdivision/PUD Filing # Lot #.
CONSTRUCTION INFO Total Building Sq Ft (not including
State Zip
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft �U Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
161 Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning Yes No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO
2nd Floor Sq Ft
31d Floor Sq Ft
Unfilshed Bsmt Sq Ft
# of Bedrooms # of Full Baths d/4 Baths /2 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 Construction (including polabor, material & profit) $ ` Q �Y� a H II C) ` 00
Description of Work I-}CMJI �rG(� �o�Ch A `S C (\cl-Ae_
Contact Name & Phone # of JOBSITE SUPERVISOR
Subcontractor Info
Electrical
Framer Roofing
Solar 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 Ion Colllliin�% rdinances and state laws regulating building construction Applicant Signature i Print Name J),5GN T'C``
,feA— PhonezQo-,D15,3PjA4
Distribution White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE