HomeMy WebLinkAbout616 Locust St - Applications/Garage - 10/04/2011City of
II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Flirt Collins >281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER QI V Ci ICJ APPLICATION DATE
Job Site Address �,jf la L_pc.u..,_A Unit #.
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # v' 1 (7 - 5-I 6 - [ 78a
Last name S t i ncxi-% First Name lc2�� Middle
Street Address (o t to L G LLB �� City ��{ (1 L(t �'1 S State C�Zip
CONTRACTOR INFO: Company Name Ckc L "c� cwnS 1 n` Contractor Phone #
Lic Holder Name �L -L ✓r. w w✓k-f n City of Fort Collins License # 1 Supervisor Cert #
Mailing Address QJ t� ��t{n A�� City ��{ L�(tflS State LG ZiptG�
LEGAL INFO
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm] Sq Ft
1s' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
Filing # Lot # Block # Lot Sq Ft
ement) Total Garage Sq Ft 66c,
# of Stories Bldg Height # Dwelling Units
31 Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/< Baths '/z Baths # of Fireplaces
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
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) 50 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ Z� OG6
Description of Work: 12j,, GL no a,)
Contact Name & Phone # of JOBSITE SUPERVISOR: 4G-✓(cam v-� q :7G 3r1( Sil Cj(,
Subcontractor Info:
Electrical P�e,,ylw-i Mechanical
Plumbing
Framer OW td..✓i Roofing OLCA 1 n..-/S Concrete 0 LPL T yr t Fireplace
Solar
Other
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 City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature Print Name ��t r L-�rAr{�c vi Phone G-7G 3L11 5'C1?(17
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE