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HomeMy WebLinkAbout409 Buckeye St - Applications/Addition or Alteration - 05/30/2014City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 www.fcgovcom/building BUILDING PERMIT APPLICATION APPLICATION NUMBER P31 40 2 (¢ Cl APPLICATION DATE*O —1 Job Site Ad 91 Unit # PROPERTY OWNER INFO: (All owner information is required- it is not optional) Phone # Last name 4<1 C.V'O-V% (� First Name �e �,w ti� �r� QMiddle CoStreet Address I c( W ��ve City jV i c4 S State W Zip 5 495a y� �y CONTRACTOR INFO: CompanyName a C w5 goy Contfactor Phone # 17©"irk(-' 703( Lic Holder Name rovttwcu y r . lltyK 1g_-� K City of Fort Collins License # Supervisor Cert# Mailing Address `161,3 SL-_%A0V1e bv. City VQ%t QXjsa.5 State CO. Zip $OSaSr LEGALINFO: Subdivision/PUD Filing # Lot # Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not Including basement) Total Garage Sq Ft Residential Sq Ft 1"Floor Sq Ft Comm'I Sq 2nd Floor Sq Ft # of Stories Bldg Height # Dwelling Units V Floor Sq Ft Unfiished Bsmt Sq Ft Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3% Baths '/ 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 # List appropriate option #s UTILITIES INFO: 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 & Description of Work: 1 0 } PAC Contact Name & Phone # of JOBSITE SUPERVISOR: 16 Subcontractor Info: Electrical Framer Solar Roofing Other Mechanical Concrete Other Plumbing Fireplace Other Applicant: I hereby acknowledge that I have read th' ap IIcation and state that the above information is correct and agree to comply with all requirements contained herein and 'ty of FortColli ordin noes d ate laws regulating building construction. t`�` Applicant Signature + Print Name _�t,YWr�!I F.RWtielalPhone g70-m[�-9®•3/ Distribution: While -Office Yellow -Applicant Pink -WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE