HomeMy WebLinkAbout1112 E Pitkin St - Applications/Addition or Alteration - 02/02/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-67 0 q-4
www.fcgov.com/building��
BUILDING PERMIT APPLICATION 4110
APPLICATION NUMBER I wv 45 APPLICATION DATE IC�'
Job Site Address 11 i a E A+�I n . , �'�. C (I I'YIS . CD Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ` -70 " a i'S- j q`f
Last name M �A" 2PrfJ.� NW FirstName ep-/K� Middle � n,,
Street Address (poi $a f Cawk� I� SOD,,,, fCiitt�y ,,�t'/-�- 6011I►15 State W Zip o a
CONTRACTOR INFO: GempaPFy fqa ie t N CG 0,.D T11 t Contractor Phone #
Lic Holder Name _ City of Fort Collins License # Supervisor Cert #
Mailing Ad
City
State Zip
LEGAL INFO: l�1 p
Subdivision/PUD Vy1i,j&e-, -cnSq L'�' Filing # Lot # 3 a Block #
Lot Sq Ft I 0 �.JD(a
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) ,15 7 Total Garage Sq Ft
i
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height IJ� # Dwelling Units
1s' Floor Sq Ft 2nd Floor Sq Ft !!�11 3rd Floor Sq Ft /V A Unfiished Bsmt Sq Ft _
361.'75
Finished Bsmt Sq Ft I DO # of Bedrooms # of Full Baths 3/4 Baths 1 '/2 Baths IV # of Fireplaces 2-
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
Citv of Fort Collins Stock Plan # AJj,4• List appropriate option #s
6. Prescriptive w/ Blower Door
UTILITIES INFO:
II //
Water Tap Size Sewer Tap Size { Metere es' or No Temp. Pedestal Yes or No
Type of Heat: N? as ❑ Electric Electric Main Breaker Size (Residential only) X150 Amp or Less ❑ 200 Amp []Other
Value of Construction (including labor, material & profit) $
Description of Work' •_
i�IS i f� Lz
� �J � E'��f eS S vu � mil) ocv s
i �s !� "1`� ty�^ � T (5 L t� f� /}w 1 �+S
(�:J 1 C.c�NG(2_Q'�.
..0 l� Lt,,
i- S"S J%�. i� t?c� ri`-fMr'• l'
y iJS 1 i i R'"nSC.o ��s-iG✓.s
G As l +^� u''"T5 �5
w � i I-1 t..)i
/r=-xi v� O J r_ t�i�C+ S `,vc
i �12� El, �'�-Z'SS /ti7 u�Dy�..� tJ mil• $''
,i
Contact Name & Phone # of JOBSITE SUPERVISOR: 00
al70 -508" 4?%15I -7 - a
Subcontractor Info:
j/j*-
Electrical
Mechanical
Plumbing
Framer
Roofing
Concrete
Fireplace
Solar
Other
Other
Other
Applicant: 1 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 F t Collins ordinances and state laws regulating building construction. �n
Applicant Signature : \ r Print Name Cr,�, 1) • it ► \« 1 I`4'— Phone 9 -70-6b%-9�5j
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE