HomeMy WebLinkAbout640 Monte Vista Ave - Applications/Addition or Alteration - 02/24/2014City 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 1514oO6i-145 APPLICATION DATE g . 24 . 2014,
Job Site Address /6 yn A&V�E Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 7 Ao t7 5 3 3
Last name a-U E First Name / % Middle /%
Street Address f7-f City r"/ (� State C�1 Zip
CONTRACTOR INFO: Company Name 619045Contractor Phone # 3
Lic Holder Name a / City of Fort Collins License # Supervisor Cart # c
Mailing Address a7� --, V EIV E City /-'%C State Cd Zip�J
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft
1 st Floor Sq Ft
Finished Bsmt Sq Ft
Comm'I Sq
2nd Floor Sq Ft
# of Bedrooms
Filing # Lot #.
Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
31 Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Full Baths % Baths '/z 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 #
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 ❑ 20O Amp ❑ Other
Value of Construction (including labor, material & profit) $ 6U) b
Description of Work: = K1.54A LL 2 g g /Lx-SS i rkz^/o49 S
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing Concrete
Other Other
V 45-3 -�
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge that ve read this pplication and state that the above information is correct and agree to comply with all requirements
contained herein and ' o o olli s rdinan d state laws regulating building construction.
Applicant Signature Print Name�MA SDA) Phone
Distribution: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE