HomeMy WebLinkAbout300 Remington St - Applications/Other - 06/04/2010City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
�t Collins 281 N College Ave Fort Collins CO 80522 0580 Phone 970 221-6760
www fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER�`'vO✓ L l!/ APPLICATION DATE
Job Site Address
PROPERTY OWNER INFO. (All owner Information Is required - it is not optional) Phone # !q in - 4f43 - %71-7
Last namenMA Pv-201F2NG. First Name p CAA,il S4wM Ga.i Middle
Street Address 300 j2GM.Ue 1+.+ s 1 city FvL Ge11.a-5 State Co Zlp�?A
CONTRACTOR INFO Company Name T13 Contractor Phone #
Lic Holder Name
Mailing
IIIL=ECT-T 9I;I"
City of Fort Collins License # Supervisor Cert #
City State Zip
si(sia,io /1612
Subdivision/PUD Filing # Lot # Block # 1 33 Lot Sq Ft
CONSTRUCTION INFO Total Building Sq Ft ( t oiud g baseme t) 3 OJ Sy F T Total Garage Sq Ft �' m
Residential Sq Ft Comm I Sq Ft # of Stones — Bldg Height # Dwelling Units —' J
1 Floor Sq Ft
31 Floor Sq Ft Unfiished Bsmt Sq Ft AV)
Finished Bsmt Sq Ft �- # of Bedrooms ' # of Full Baths / Baths / Baths ^ # of Fireplaces
Air Conditioning Yes No Energy info ( Circle appropriate choice) 1 ComCheck 2 ResCheck w/Air Sealing m
3 ResCheck w/Blower Door 4 Simulated Performance Alternative 5 Prescnpbve w/Air Sealing 6 Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option #s fb
UTILITIES INFO.
Water Tap Size_ Sewer Tap Size /y!H 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
e_ .f fgpp F.(CC
Value of Construction (including labor matenal & profit) $
O O /$� O DD p+++ pPn.... [
Description of Work C-[V\1ZS - Li atc-les e, ov
1.j # N Awila.dAPA it &c &..T tcsd&6. ..A If. I eu ierj"A a I ryt%. aAJ 61A; %Ii sd'cei
2n° Floor Sq Ft
Contact Name & Phone # of JOBSITE SUPERVISOR
Subcontractor Info
Electncal
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
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 ordinanc and state laws regulating building construction II ..
Applicant Signeture Print Name �1 tJIJ .I`rArtttS Phone �0&r 933-Ak
Foe. C);rgK w tiC- 7
Distribution White - Office Yellow - Applicant Pink - W W W/Stomiwater
MAY 21-2010 08 54A FROM DMA PLAZA INC
City of
Fort Collins
970 493 7757 TO 14053294037 P 1 1
Planning Darelopmant A Transportation
281 N College Ave P 0 Box 580
Fort Collins OD 80524
Phone 970-416-2740 Fax 224-613
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I. (Print) LII Av S A�w & ' m a":cA as owner of record (property
address) Son known as (name of
business) lbimfx il"AlozbK. hereby authorize the
work listed below to be done on said property I understand that such work will only be
performed contractors licensed by the Ctty of Fort Collin&
❑ I am giving permission for interior work only The scope of the work shall be
limited to
❑ I am giving permission for witerlor worts only The scope or the work shall be
limited to
we am giving meson for Ik�rior and
G e�actj gee / .0 -Dbtu
limited to
work The scope of the work shall
The foregoing affidavit was aduaMadged before me on the S - day of
6 /0 (month year) hX,�Q
for the pureW therein set forth off, A FqF
4
Witness my hand and offidal seal N O T g q y
My Commission expires 7
�09/2011
N
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Permit* -
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