HomeMy WebLinkAbout1611 S College Ave - Applications/Tenant Finish - 06/30/2008 (2)r
City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 - Fort Collins, CO 80522-0580 - Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
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APPLICATION NUMBER GJ ` V � APPLICATION DATE 62
Job Site Address
PROPERTY OWNER INFO: (All owner information is required - it is not optional)
Unit # -7 C-
Phone # (17V� 7,1q
Last Name t' t' (TA\ltTHRar.l First Name' 2a Middle
Street Address � LA cA, \.i. r!t y � �;n Agi: City fin. Co3 , State-C�Q Zip S'?
CONTRACTOR INFO: Company Name �D £ t -t A Co r STr i i L-r f r, NI Contractor Phone #_ C-1?,?� Li - <?7 & le
Lic. Holder Name Ll-gx. h nCr?- City of Fort Collins License # Supervisor Cert # 1319-A
Mailing Address 20RLar,�City 1;a (DW,'-� State CCU Zip SZy1
LEGALINFO:
Subdivision/PUD r-OX ;,�A nP P�wCr G ,r/t FT� Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not induding basement) `i) 2 9 47' Total Garage Sq Ft
Residential Sq Ft
131 Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes
3. ResCheck w/Blower Door
_ Comm'I Sq Ft �� # of Stories Z, Bldg Height s�- & # Dwelling Units
_ 2nd Floor Sq Ft '7
{/ ! o Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
_ # of Full Baths % Baths '/z Baths # of Fireplaces
No Energy Info: (Circie appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
City of Fort Collins Stock Plan #
4. E-Star w/Blower Door
UTILITIES INFO: f
Water Tap Size / 7 Sewer Tap Size.
Type of Heat: XGas ❑ Electric Electric Main Bre
Value of Construction (including labor, material & profit) $_
5. Prescriptive w/Air Sealing
List appropriate option
Metered: es or No
6. Prescriptive w/Blower Door
Temp. Pedestal: Yes or No
Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Description of Work: T S t I Qr r a t o (r M s r `n Ar , f C-A t Fr e �,671 I f All IP t V r41 T, (f f
IV 512 C r I <tn �C
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical (< i,d rr,.) �:d? Mechanical Plumbino � ,T,'i I t> 5
Framer (,U�- CCn QP, rJ Roofing i-� Co rj -, �7 A rj C � Concrete 7) fr V, �x Other
Applicant: I hereby acknowledge that I have re is application and state that the above information is correct and agree to comply with all requirements
contained herein and City of F C fins in ce's and state laws regulating building construction.
Applicant Signature Print Name MCLA,)UY`rpnj Phone `I-7o zlq-) S�
Dis on: White - Office Yellow -Applicant Pink - W W W/Stomnvater
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