HomeMy WebLinkAbout257 Pascal St - Applications/Addition or Alteration - 08/13/2015Citty oaCollins
I I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER a 150 (GO`19 APPLICATION DATE v -'3 - 15
Job Site Address cey- Sf Unit #,
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # / 7,0 Z/ 7 — 5-;:!� e/
Last name_ // First Name - Ca P" 0-1-7 Middle % p
StreetAddress���% Cl��CCLL ///�S� City /F� 401111?S State eO Zip p0s7-
CONTRACTOR INFO: Company Name%%loTTc/ / /19f. C6W7,6rt7e lor5 Contractor Phone # 770 Z Z 7'%p"Y
Lic Holder Name �t:0 �`eYI City of Fort Collins License/# 650 Supervisor Cert #o�9G3-�
Mailing Address 30.575 /kad-5 on 4:111 �_ City Lo v�//�[ O� State �O Zip �o�-3
LEGAL INFO:
Subdivision/PUD 0/CG /oU/N/ /Vr71-T/7 Filing # Lot # 1 2- Block # Lot Sq Ft 7J8 SO
CONSTRUCTION INFO_ Total Building Sq Ft (not including basement) 37� LI& 80 Total Garage Sq Ft q 6 1Q
Residential Sq Ft �30 q l Comm'I Sq Ft O # of Stories_ Bldg Height 3 8 t # Dwelling Units Z
V Floor Sq Ft ./:-� � 16CJ72M Floor Sq Ft / 0 / 31d Floor Sq Ft I Z S Z Unfiished Bsmt Sq Ft N
Finished Bsmt Sq Ft N i # of Bedrooms. # of Full Baths 3 % Baths Q '/z Baths /_ # of Fireplaces
Air Conditioning: Yes 0 Energy info:( Circle appropriate choice) t. 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 #
UTILITIES INFO:
List appropriate option #s
Water Tap Size Sewer Tap Size Metered Yes or No Temp. Pedestal Yes or No
Type of Heat: [was ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $:3 5-0O . OO
Description of Work: Zy7, all a- 7o-i✓owjo QnlVakii/
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer Roofing
Solar Other
Mechanical
Concrete
Other
e '770
Plumbing
Fireplace.
Other
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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
Print Name
Phone
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE