HomeMy WebLinkAbout940 PIONEER AVE - APPLICATIONS - 2/16/2018City of . COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281-N. College Ave.'* Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
a i BUILDING PERMIT APPLICATION
APPLICATION NUMBER �.� `�''l J "`-APPLICATION DATE
Job Site Address Q - Unit #
PROPERTY OWNER INFO: (All owner information is required -it is not optional) Phone #
Last named First Name Middle
Street Address���6bEn 5l JC City ii 4 1 ' State 1
CONTRACTOR INFO: Company Name Contractor Phone # I DA
Lic Holder Name,. f Isar) City of Fort Collins License # Wr05Z'Supervisor Cert #3e&-5M9n
Mailing Address YU I 1 City ! State_ Zip
LEGAL INFO '
Subdivision/PUDC)ar j�;�'I Filing # Lot #Z� lock # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basementL 50J '"iT Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft i # of Stones ' Bldg Height # Dwelling Units
Is1 Floor Sq Ft 2n0 Floor Sq Ft 3b Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms`. # of Full Baths % Baths '/2 Baths, # of Fireplaces
-Air Conditioning: YeNo Energy info: ( Circle appropriate choice) 1. ComCheck ❑ 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Altemative❑ 5. Prescriptive w/Air Sealing 6. Prescriptive w! Blower Doora
City of Fort Collins Stock Plan # List appropriate option #s '
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes -]No[—] Temp. Pedestal Yes❑ No ❑
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) F-1150 Amp or Less ❑ 200 Amp DOther
Value of Construction (including labor, material
& profit) $
Description of Work: (12. ,01-, ( `I'- nOGb�
Contact Name & Phone # of JOBSITE.SUPERVISOR:-
Subcontractor Info:
Electrical Mechanical - Plumbing
Framer -Roofing Concrete Fireplace
Solar Other Other Other
Applicant: I hereby acknowledg h I have read is applicatio nd state that the above information is correct and agree to comply with all requirements
,thcontained herein and City of F/ C ins Vlrha sand s regulating building construg.4io .
Applicant Signature / nt Name // VPhone I /'.' WZ / 6)9
Distribution: White — Office Yellow —Applicant 'Oink- WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE