HomeMy WebLinkAbout926 Akin Ave - Applications/Addition or Alteration - 06/19/2014City of
Fort Collins
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COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740 ;t r rO " )�
www.fegov.com/building
BUILDING PERMIT APPLICATION ` t
APPLICATION NUMBER gkzs :Vk APPLICATION DATE `0 [R- A SOU S
Job Site Address 9X, AILS., Ave--jaE Unit #
PROPERTY OWNER INFO: (All owner Information Is required- it is not optional) Phone # 970 - .i1$ -R 331
Lastname GUFV. srsY First Name 305406 Middle
Street Address 99(o AtfTAvex&,9 City F�wr tdu,%�& State W Zip 5b5af
CONTRACTOR INFO: Company Name �i ewcjLAp-r &-%W&Ps Contractor Phone # 970 -H7;1-9100
Lic Holder Name City of Fort Collins License # D -597 Supervisor Cert#
Mailing Address yo79 ra flown S70AEr City )TR, G..e d--. State CO Zip eo.Sd�
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Subdivision/PUD # 1159 - PL2.-�Pu[ r P wc& Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not Including basement) Total Garage Sq Ft
Residential Sq Ft Comml Sq Ft # of Stories Bldg Height # Dwelling Units
1" Floor Sq Ft 2nd Floor Sq Ft 3" Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms 01 # of Full Baths % Baths '% Baths # of Fireplaces
Air Conditioning: YerNo Energy Info: ( Circle appropriate choice) 1. ComCheck ❑ 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door H4. Simulated Performance Altemative❑ 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes❑NoF-1 Temp.Pedestal Yes❑ 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 & profit)
Description of Work: AN) o2 NtW BED P�ooMf vN 7-H6 DER LeVEL. , 1zarnove, F;=ejptgeg o.v )414- .Ev6LS,
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Contact Name & Phone # of JOBSITE SUPERVISOR: GnRDon iV1,' -eR - SGrr- 3y3 b
Subcontractor Info:
Electrical 3A aeerm,c& Mechanical AV-Segsov5 Plumbing
Framer gusu75MAWT Roofing LA2Azo5 Concrete
Solar
Other
Other
Fireplace
Other
Applicant I hereby acknowledge that I have read this application and stale 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 9� Print Name J dfLEMy Yni Lt r Phone 97o -OR-16 oo
Distribution: White -Office Yellow -Applicant Pink -WWW/Stonnwater
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