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HomeMy WebLinkAbout6132 POLARIS DR - APPLICATIONS - 10/2/2017City }of I I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES F6rCollins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416-2740 tivww fcgov com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER ' / O 62 O'er APPLICATION DATE I O-GY • I Job Site Address 6VtStS Unit # PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Q0 C� - yc�0 . 5AON=� Last name �Co t.J riL `. First Name., Ci �1J Middle Street Address %��� �O\P.SL1.� �� City QJ='"AL.>4,, StateC'(2�' Zipg ' rJ CONTRACTOR INFO: Company g3�%> So 9-ue-1V.Catntractor Phone # kTd - %Vt)' @ 3� Lic Holder Name \r . NVQ.y- City of Fort Collins License # 0-- V*% Supervisor Cert # Mailing Address_\6Vfl \ n�.1�9���. (,'.� CityroQ�t �'pua►�� Stater Zip12 LEGAL INFO: Subdivision/PUD V�©Qp.`�.� ` Filing # Lot # Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft Residential Sq Ft Comm'I Sq 1" Floor Sq Ft 2nd Floor Sq Ft # of Stories Bldg Height # Dwelling Units 3" Floor Sq Ft Unfiished Bsmt Sq Ft Finished Bsmt Sq Ft - # of Bedrooms CO # of Full Baths % Baths \ '/2 Baths # of Fireplaces Air Conditioning: YeGo0 Energy into: ( Circle appropriate choice ) 1. ComCheck E1 2. ResCheck w/Air Sealing 11 3. ResCheck w/Blower Door ❑4. Simulated Performance Alternative❑ 5. Prescriptive w/Air Sealing11 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 []NoF—1 Temp. Pedestal Yes❑ No ❑ Type of Heat: ❑ Gas ❑Electric Electric Main Breaker Size (Residential only) F-1150 Amp or Less 1-1 200 Amp 0Other Value of Construction (including labor, material & profit) $ Description of Work: V, %%z V. C>% VN N%.i- V-amS'-%., Contact Name & Phone # of JOBSITE SUPERVISOR: Y\�Vt.zo. Subcontractor Info: Electrical MechanicalCiV. =a VWL04N WG �6 Plumbing eS>'.L-jQA'thZ O FramerRoofing Solar Other Concrete Other 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 andlfFo C ins ordi s and state laws regulating building construction. Applicant Signature z eo— Print Name "S%-k 7�� iY W Phone q'Ic> - `�' to,�Sb Distribution: White - Office Yellow -Applicant Pink - W W W/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE g443