HomeMy WebLinkAbout6315 FALL HARVEST WAY - APPLICATIONS - 10/13/2017City of
II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
�t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
5 i'-d 11 aa.rit e�-( ww &/"g nit #
PROPERTY-OWNERINFO: (AII owner information is required — itis not optional) Phone # { /0 D/ T
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Last name PILA n e First NameMiddle 1JG V L
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Street Address �5 K r(p Cdy t t• �� I I III 1 State d Zip
CONTRACTORINFO Company Name 1,J o n I 01 le i Contractor Phone # qZ— 2Zz -(Z74
Lic Holder Name IV —-"
IA
City of Fort Collins License # Supervisor Cert #
Mailing Address_
LEGAL INFO
Subdivision/PUD
City
Filing # Lot #.
State Zip
Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
2ntl Floor Sq Ft
3 °Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft 10# of Bedrooms--
# of Full Ba Baths
'/�Ba�thstil'/, Bathsv # of Friirep PV
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
material & profit)
M
o) % e m a o 7 Jx l" 1 l',f110 /3 oevt I IV nd Y�r) t ice) q'-�k
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcorit actor Info:• ',
Electrical }! rS ilQ(,li"L Mechanical ✓dUr ky atj(IAA.de Plumbing L( J('lct
Framer Roofing f F Concrete �Y Fireplace AZA
Solar 0 / k Other Other 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 C lims ordinances and state laws regulating building constructto L "7
—Applicant-Signature�[l�I Print Name Kew) � ) Phone / —22?JW07�
Distribution White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE