HomeMy WebLinkAbout728 Rocky Rd - Applications/Change of Use - 09/09/2015Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER. i�JV `�(�D� APPLICATION DATE
Job Site Address728 Rocky Road
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone
Last name Lefsky First Name Michael
Street Address 728 Rocky Road City' Fort Collins State CO Zip80521
Unit#1
CONTRACTOR INFO: Company Name Self
Lic Holder Name
Mailing Add
LEGAL INFO:
Subdivision/PUDH ESS
9709809036
Middle Andrew
Contractor Phone #
City of Fort Collins License # Supervisor Cert #.
City.
State Zi
Filing # 1294 Lot #2 Block # Lot Sq Ft8196
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft 6240 Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
151 Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/ Baths # of Fireplaces
Air Conditioning: YerNon Energy info: ( Circle appropriate choice ) 1. ComCheck11 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door ❑4. Simulated Performance Alternative❑ 5. Prescriptive w/Air Sealing 11 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
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) F-1150 Amp or Less 11 200 Amp DOther
Value of Construction (including labor, material & profit) $
Description of Work: X-0-
Install sleepers over con
A/o
00
Contact Name & Phone # of JOBSITE SUPERVISOR: Michael Lefsky 970 9809036
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
ns
Mechanical 6(L� r"�il!,(�tSil4q Plumbing
Concrete
Other
�e�tcel d .`tee �
cover was(drywall)
Fireplace
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 Print Name M ichael Lefsky Phone 9709809036
Distribution: White - Office Yellow- Applicant Pink - VWWV/Stormwater