HomeMy WebLinkAbout411 S BRYAN AVE - APPLICATIONS - 10/15/2018COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
APPLICATION
Job Site Address
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION
Unit #
w
I aai-(�
PROPERTY OWNER INFO: (All owner information is required — it is n t optional) Phone #
Last name e/Ty 4� : �'�///�First Name I e
Street
LEGAL INFO:
— City C�State Zip /
Contractor Phone #
License # F ��� Supervisor Cert # / /Z465 -�
State Zip.
Subdivision/PUD 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 Ft # of Stories_ Bldg Height l # Dwelling Units
I$1 Floor Sq Ft 2nd Floor Sq Ft V Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths % Baths # of Fireplaces
Air Conditioning: Yes 40 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 # List appropriate option #s
UTILITIES INFO- ,�/
Water Tap Size ,Y Sewer Tap Size /v X 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 ❑ Otherr/{//
Value of Construction (including labor, material & profit) $
Description o �ork: AZII L//j y`��/
/f/ ✓ fc 00= lr�
Contact Name& Phone # of JOBSITE SUPERVISOR:64!? i4e/�— %/�`,( / �� /_ JW
Subcontractor Info -
Electrical Mechanical /lLl�- Plumbing llZ,,4
Framer'T%i//5/f�/ lO�� Roofingr/6%/i��TaCLLIr Concrete (!'/ /! fP��ireplace
Solar Q 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 Collins o finances a d state laws regulating building c��onyystr��uction.���c� �f
Applicant Signature ��®%�" Print Nam�4 �mwt- Phone//U' �/ -ZF
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE