HomeMy WebLinkAbout609 WHEDBEE ST - APPLICATIONS - 9/20/2016City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER I `�yy v � APPLICATION DATE � I t, I
Job Site Address f90 9 W Unit #.
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # Q % 0 ' fill 2 ' 4 % % 1
Last name t'U t e n1
First Name
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Middle V
Street Address l9(q L.)•
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City F1 • (� 11 t/ $
State PJ zip S2
CONTRACTOR INFO: Company Name
Lic Holder Name
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
Mailing Address City State
LEGAL INFO:
Subdivision/PUD IJV tO k 9t - C T L & IL I S(0 Filing # I q 1 (� Lot
,#,) 5 Block # 15& Lot Sq Ft 9 s o b
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) C �� f �J o� Total Garage Sq Ft Z I Co
Residential Sq Ft Za 5 b Comm'I Sq Ft # of Stories 2 Bldg Height ' si xy # Dwelling Units
1" Floor Sq Ft I O Z 5 2nd Floor Sq Ft 10 Z 5 3rd Floor Sq Ft
Unfiished Bsmt Sq Ft 322
Finished Bsmt Sq Ft O # of Bedrooms 3 # of Full Baths Z % Baths /2 Baths I # of Fireplaces 1
Air Conditioning: Ye 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: M Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)
Description of
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Contact Name &Phone # of JOBSITVISOR:
Subcontractor Info: O
4u r.r odcl r fry n w l ICr l c tv
AT
Electrical b1 JkLeA CCLC.t-VL—T— Mechanical Oxc k -5 + 4 Plumbingj�pk- YIU, L3,vt-°
Framer 14 7 QA-kot;L I Roofing 04& J,-64L & Concrete
Solar
Other
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 and City of Fort Collins ordinances and state laws regulating building construction. t
Applicant Signature Print Name ,„� �w. �r5[r w e n Phone q1 i I Z' y 77
Distribution: While - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE