HomeMy WebLinkAbout124 Fishback Ave - Applications/Addition or Alteration - 05/10/2013City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
/ www.fcgov.com/building
h Q7� BUILDING PERMIT APPLICATION
APPLICATION NUMBER �1 V I i) V APPLICATION DATE ✓ 1
Job Site Address 124 Fishback Avenue Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 970-490-2962
Last name Reffler First Name Cynthia Middle
Street Address 124 Fishback Avenue city Fort Collins . State CO Zip 80521
CONTRACTOR INFO: Company Name CJR Construction Contractor Phone # 970-490-2962
Lic Holder Name Bruce Brown City of Fort Collins License # D554 Supervisor Cert #
Mailing Address 124 Fishback Avenue city Fort Collins State CO Zip 80521
LEGAL INFO:
Subdivision/PUD Babbitt Filing # Lot # 11 Block # 3 Lot Sq Ft 9500
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 2099 Total Garage Sq Ft 727
Residential Sq Ft Comm'I Sq Ft # of Stories 1 Bldg Height 11 '8" # Dwelling Units
1" Floor Sq Ft
2n° Floor Sq Ft
3' Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/. Baths 1/: Baths # of Fireplaces
Air Conditioning: Ye Go Energy info:( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower boor Iq
4. Simulated Performance Alternative S. Prescriptive w/Air Sealing S. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
Water Tap Size . Sewer Tap Size Metered: Yes F1NoF-1 Temp. Pedestal Yes❑ No El
Type of Heat: Gas ❑Electric Electric Main Breaker Size (Residential only) F-1150 Amp or Less 11 200 Amp Other
Value of Construction (including labor, material & profit) $ 2000
Description of Work:
Build a greenhouse adltlo 0 3
Contact Name & Phone # of JOBSITE SUPERVISOR: Cynthia Reffier 970-215-6118
Electrical Lary Eight Electrics Mechanical
Framer
Solar
Roofing
Other
Concrete
Plumbing
Fireplace
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 of Fort Collins ordinanggs and state laws regulating building construction.
Applicant Signatt/ LPrint Name Cynthia Reffler Phone 970490-2962
Distribution: 1Nhite-Office Yellow - Applicant Pink -NMAN/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE