HomeMy WebLinkAbout215 E Foothills Pkwy - Applications/Demolition - 05/21/2014I OB!" 13013 0
+�itF Ot COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F®i t Collinsls 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fegov.com/building
Intl L DING PERMIX APPLICATION
APPLICATION NUMBER APPLICATION TE .!�� 7,;)- /_4�(
lob Site Address_
DROPERTY OWNER INFO: (All owner information is required — It Is not optional) Phone #=j
-ast name "�c°� i�Na s � �-
�ih.,c,L A-- Middle
41reet Address_ c\Z�c� LJ n fwe .fie. ftM City Slate i L-.. Zip13
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CONTRACTOR INFO: Company Name +��T'�f�P _ (�ameG l:�n Contractor Phone # 3a�-Y21 331n to
-ic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address C'To � CE!'\-p1C- ' ywc . C_ City Ar.tr.Ao. State Cp • Zip jbcz L
_EGAL INFO:
3ubdivisionlPUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)_ 131 �ZU Total Garage Sq Ft
:Zesidenlial Sq Ft Comm'I Sq Ft # of Stories Bldg Height _# Dwelling Units
I � Floor Sq Ff 2"° Floor Sq Ft 3itl Floor Sq Ft Urifiished Bsmt Sq Ft
=inished Bsmt Sq Ft # of Bedrooms # of Full Baths _ 3/, Baths 1A Baths _ # of Fireplaces
4ir•Mriditioning: Ye No Energyainfo: ( Circle appropriate choice) 1. ComCheck D 2. ResCheck w/Air Sealing ❑
i. ResCheck wlBlower Door ❑ 4. Simulated Performance Alterri Uver 5. Prescriptive w/Air Sealing 6. Prescriptive wl Blower Door
wily of Fort Collins Stack Plan #
List appropriate option
JTILITIES INFO:
Jater Tap Size Sewer Tap Size Metered: Yes Ebor Temp. Pedestal Yes No
rype of Heal: nGas Electric Electric Main Breaker Size (Residential only) r150 Amp or Less ❑ 200 Amp Other.
Value of Construction (including labor, material & profit) $ 7 Q� vta to
Contact Name & Phone # of JOBSITE SUPERVISOR: �' M !Q. 1 --, ?z6q-s--1 LAI - 22k-1 �
Subcontractor Info:
Electrical Mechanical Plumbing
Framer Roofing Concrete 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 rq`�r.e� (V\r, Print Name `�o�or:r�c.� l,7Lr�c+' Phone 421-331,V
Distribution: While - Office . Yellow - Applicant Pink - VNMWIStormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE