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Home My WebLink About3527 SUNFLOWER WAY - PERMITS - 1/4/2021Owner:BURNS SAMUEL/MAURA 4848 KING ST DENVER,CO 80221-1022 Phone:773-860-6469 Zoning:Front setback:Rear setback:Right setback:Left setback: Minor Amend #:Plat File #:ZBA Case #: Zoning district:RF -RESIDENTIAL FOOTHILLS DISTRICT Legal:Subdivision/PUD:Filing #:Lot #:149 Block #: Code:Res sq ft:0 Com sq ft:Ind sq ft:Basement sq ft: #of stories:Occ Group:Const Type:V-B Fire Sprklr:Stock plan #:Stock plan options: Contractor:POUDRE VALLEY HOME IMPRV PO BOX 1119 FORT COLLINS,CO 80522 License #:D-508 Phone:970-472-8410 Supervisor cert #:2235-D1 Subcontractor(s)Phone License Number Electrical:LAMB ELECTRIC,LLC 970-493-8628 ME-1340 Mechanical:TRI CITY HEATING &AIR CON 970-493-0126 H-1980 Plumbing:RAM'S PLUMBING INC 970-690-8997 MP-534 Work Description:Kitchen remodel to include new electrical ,re-location of laundry hook ups and structural alterations.Additional bedroom to be added by enclosing an existing loft space.Job Contact:Dan Bucholt 970-481-8410 SCHEDULE INSPECTIONS:**via Text Message:888-406-6394 **By Phone:970-221-6769 **Online Portal:fcgov.com/CitizenAccess **Online Portal via Mobile Device:fcgov.com/CitizenAccess/mobile Possible Inspections Required:206 200 202 204 100 101 102 203 205 201 207 303 301 300 302 TOTAL FEES PAID AS OF 01/06/21:$3,072.76 Payment method:Credit Card 5981 **Fee Detail Displayed on Next Page As a condition for the issuance of a permit,I hereby declare that I am the owner or owner's agent,authorized to perform the proposed work on the property described herein. I agree to comply with all the requirements contained herein,and City ordinances,and State laws associated with such work.I understand that such permit may be revoked in the event that issuance was based on incorrect information.This permit shall become null and void if the work authorized by such permit is not commenced, suspended,abandoned or not inspected within 180 days from the date of such permit. Carbon Monoxide Alarm required within 15 feet of each bedroom entrance. Community Development &Neighborhood Services 281 N.College Ave Fort Collins,CO 80522 970.221.6760 970.224.6134 -fax Building Permit #:B2013849 Issued Full:01/06/2021 Permit Type:Residential Alteration Site Address:3527 SUNFLOWER WAY Job Valuation:$75,000.00 Category:Residential Remodel Signature:Print Name:Date: Form Revised Oct 2010 Transactions Method Check Number Date Paid Amount Paid Comments Credit Card CK #5981 01/06/2021 $2,640.83 Credit Card CK #5981 01/05/2021 $431.93 Receipt issued:01/06/2021 Total Paid to Date:$3,072.76 Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due Building Permit Fee w/Subs 1000.422010 $897.08 $897.08 01/06/2021 $0.00 City Sales/Use Tax 251.122030 $1,443.75 $1,443.75 01/06/2021 $0.00 County Sales/Use Tax 100.217030 $300.00 $300.00 01/06/2021 $0.00 Plan Check Fee 1000.444010 $431.93 $431.93 01/05/2021 $0.00 TOTAL FEES:$3,072.76 $3,072.76 $0.00 TOTAL BALANCE DUE AS OF 01/06/2021:$0.00 Community Development &Neighborhood Services 281 N.College Ave Fort Collins,CO 80522 970.221.6760 970.224.6134 -fax Building Permit #:B2013849 Issued Full:01/06/2021 Permit Type:Residential Alteration Site Address:3527 SUNFLOWER WAY Job Valuation:$75,000.00 Category:Residential Remodel Fee Amounts are valid for date of this document only.Fees subject to change without notice. Form Revised Oct 2010 COMMUNITY DevelOpMeNT & NeIGHBORHOOD SeRvICeS THIS ApplICATION eXpIReS 180 DAYS FROM ApplICATION DATe APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740 www.fcgov.com/building APPLICATION NUMBER__________________________________________ APPLICATION DATE________________________________________ APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution: White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit) $__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO : (All owner information is required – it is not optional) Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ # Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________ List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater APPLICATION NUMBER______________________________________ APPLICATION DATE_____________________________________________ Job Site Address_________________________________________ Unit #______________________ PROPERTY OWNER INFO:(All owner information is required – it is not optional)Phone #_______________________________________ Last name________________________________ First Name_____________________________ Middle __________________________ Street Address__________________________________________ City___________________________ State________Zip____________ CONTRACTOR INFO: Company Name __________________________________ Contractor Phone #______________________________ Lic Holder Name _____________________________________ City of Fort Collins License #___________ Supervisor Cert #___________ Mailing Address________________________________________ City____________________ State____________ Zip________________ LEGAL INFO: 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’l Sq Ft_____________ # of Stories_______ Bldg Height__________ #Dwelling Units ___________ 1st Floor Sq Ft ___________ 2nd Floor Sq Ft ___________ 3rd Floor Sq Ft __________ Unfinished Bsmt Sq Ft____________ Finished Bsmt Sq Ft __________ # of Bedrooms _____ # of Full Baths _____ ¾ Baths _____ ½ Baths _____ # of Fireplaces _____ 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 # _____________________List appropriate option #s__________________________________________ UTILITIES INFO: 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 Value of Construction (including labor, material & profit)$__________________________________________________________________ Description of Work:_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Contact Name & Phone # of JOBSITE SUPERVISOR: _____________________________________________________________________ Subcontractor Info: Electrical ___________________________ Mechanical ______________________________ Plumbing ___________________________ Framer ____________________ Roofing ____________________ Concrete ____________________ Fireplace _____________________ Solar ______________________ 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 Collins ordinances and state laws regulating building construction. Applicant Signature___________________________________ Print Name___________________________ Phone __________________ Distribution:White – Office Yellow – Applicant Pink – WWW/Stormwater 1st Floor Sq Ft _______________ 2nd Floor Sq Ft _______________ 3rd Floor Sq Ft _______________ Unfiished Bsmt Sq Ft ______________ B2013849 1/6/2021