HomeMy WebLinkAbout1820 S College Ave - Applications/Addition or Alteration - 01/05/2012City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
�t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
y��7 %� BUILDING PERMIT APPLICATION
APPLICATION NUMBER V 12-j10000,T�IAPPLICATION DATE (� CD _ I
Job Site Address M-0 �)cvHx b§%� NOC, (gig)
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PROPERTY OWNER INFO: (All owner information is required - It is not optional) Phone # 1 gig tU b 1- 0 5 -� 7
Last name 10M/ 90(\_ I First Name ACACA 0 Middle
Street Address l OZ0 S. ColkjL �pe• City a. C'1.�,t� 5 rSState�Zip 9L�
CONTRACTOR INFO: Company Name 1 ml u �ov^ r �M-knaCoatractor Phone # 1� 9 9 9 3 ���31
Lic Holder Name ffG.�U1/� 1K���'� ppl�t PPCity of Fort Collins License # e� . Supervisor Cent #
Mailing Address �A 1 11+ F . Imo- o,\ P V . _4" I V 1l0 City S,)gWV-L-r State Cd zip-...- 1a-
LEGAL INFO: ^hcum� `,115'/41[ol 155
Subdivision/PUD Mons 5v� Filing # ldt�#o �ro� Block Lot Sq Ft 2B
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) '1 101SH`'t� Total Garage Sq Ft
Residential Sq Fat Comm'I Sq Ft of Stories_ Bldg Height # Dwelling Units
ls' Floor Sq Ft 1 %� 2nd Floor Sq Ft 3rd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths — 3/4 Baths '_ '/2 Baths 2 # 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: A
Water Tap Size WTI Sewer Tap Size N/]k Metered es r 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 & profit) $ ZZ, Z �S
Description of Work: 1 tlOh (IJohn-WA CA. VQa1tAJ4'
Contact Name & Phone # of JOBSITE SUPERVISOR: oq o I `A-t
Subcontractor Info:
Electrical Mechanical Plumbing
Framer R000�fofit77ng f� Concrete Fireplace
Solar t rr �� 6 �• 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 s^tatee laws regulating building construction.
Applicant Signature A .��/ Print Name Phon� t �O�
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater -T-r0 y
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE