HomeMy WebLinkAbout257 Pascal St - Applications/Duplex - 01/10/2014City of I 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 APPLICATION DATE
Job Site Address 2S7 Paga l -5} F? 6 n' 6 Unit #
6rU5a V
PROPERTY OWNER INFO: (All owner Information is required - it is not -optional) Phone #
// Last name e,*i fra First Name //GLYYld-l? Middle
Street Address aE:7
I
City Fot-Z 60111n.5
State_41(�) Zip O62S
li&Sa
CCILM CTOR INFO:
Company Name
Contractor Phone #
Lic H e Name
Mai' g dress_
L A INFO:
Su ivision/PUD
ONSTRUCTION Ilk
Res' ential Sq Ft _
Floor Sq Ft
Fin' ed Bsmt Sq Ft
Total Building Sq Ft (not including
Comm] Sq Ft
20d Floor Sq Ft
City of Fort Collins License # Supervisor Cert #
City_
State
Filing # Lot # Block # Lot Sq Ft
nest) Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/< Baths '/z Baths # of Fireplaces
Ai7scheck
ditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. 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: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)
-Description
Contact Name & Phone # of JOBSITE SUP
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge that I have read this applicatioyp� and state that the above information is correct and agree to comply with all requirements
contained herein and City o Ilins ordinances and state 5ws regul g building construction.
Applicant Signature Print Name-bet.'na / %/G�i' 4% Phone 770
Distribution: White ice Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE