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HomeMy WebLinkAbout128 N Mckinley Ave - Applications/Addition or Alteration - 05/03/2012 (2)COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES Fort Collins 281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760 www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER 4a D_�� APPLICATION DATE orL Job Site Address / tc k .n rev Unit # PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 3 ©'�- t l g -1 Last name -ed; n� First Name ,fit KA a (Ruw,tl ✓I Middle Street Address a /4 c k, ^ I 2y State C O Zip TO 5- CONTRACTOR INFO: Company Name 8 + CD✓'7<ra Ci l ^q Contractor Phon 9 i O ';L '7 - 17 "7 jLic Holder Name De, V; � City of Fort Collins License b-59 ( S pervisor Cert # Mailing Address 16 Qw ck e- 5'(--- City FI: Cm t l r^5 State Zip 705 � y LEGAL INFO: Subdivision/PUD Filing # Lot # Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units 15' Floor Sq Ft 2nd Floor Sq Ft 31d Floor Sq Ft Unfiished Bsmt Sq Ft Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 1/4 Baths '/2 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 & profit) $ 3 70 o f3sn,t 6l� w ndio(� Description of Work: Cey� ��i 5'1 t ry W � ✓1 vvAso h n 6V C^�i^7 2xiS'%l`�s�etvii..,, S �.c)S � ��w✓I. L' T V J tXr"'� e— Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: ,/d Electrical ILIA Mechanical NA �/ e Plumbing A/14 � / Framer /V/.I Roofing /v A, Concrete !v A Fireplace Nl� 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. r— Applicant Signature � �yt�(= _ Print Name oy, i F" h KI' i i n Phone .770 a'1. % ff Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE