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Home My WebLink About750 Jerome St - Applications/Single Family New - 12/03/2015 (3)��Ciity of COMB UNITY DEVELOP MENT & INEUGH ORHO®® S ERVICiES �t Collins 281 W. College Ave. - Fort Collins, CO 80524 • Phone: 970-416-2740 wwwAcgov cooa/bullding APPLICATION NUMBER 15 v I I APPLICATION DATE ' a/ Job Site Address 750 11aciril��r,,E _.SIRE`'( Unit # i PROPERTY OWNER INFIOrr:_ (All owner information is required- It is not optional) Phone # I lLf Last name 1IKfllll! Ut First Name Middle JJ Street Address_ )ilSf.Ql..?TN (( cityy�f/jjljiri State 7G Name LY1Hfd 1 iMi fityrTrg -liar ( Contractor Phone # gTE/F 5 CONTRACTO IN O: Company p r License 4-1-AL— Supervisor Cert #_ Lic Holder Name (!'iLt& 1/0ditf __ City of Fort Collins _ IV�10�(/III� il�ll�t - k '( UIiAINs State 2 Zip_1W5____ MailingAddress —City. LEGAL INFO: iA `'F Subdivision/PUD r'tfl I'riuN _j.j�'�tt Fling# _.... ,,,_ ._ Lot# _ Block# 17 LotSgFt_I, CONSTRUCTION INFO: Total Building Sq Ft (not Including basement) L 3 Total Garage Sq Ft Residential Sq Ft 13_CComml Sq Ft= # of Stories�3Bldg Height , "•"r # Dwelling Units 11 1" Floor Sq Ft A;—_ 2n0 Floor Sq Ft.. 3w Floor Sq Ft g3 Unflished Bsmt Sq Ft _ .a Finished Bsmt Sq Ft _ # of Bedrooms �_ # of Full Baths % Baths �_ 'h Baths _I..__ # of Fireplaces Air Conditioning: YesmNou Energy info: ( Circle appropriate choice ) 1. ComChec c�. 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternatives 5. Prescriptive w/Air Sealing u 6. Prescriptive w/ Blower Doo� City of Fort Collins Stock Plan # List appropriate option #s UTILITIES INFO, l�l Water Tap Size FX&P1� Sewer Tap Size E�_ Metered: Yes ZNol � Temp. Pedestal Yesa No Type of Heat: Dx Gas Electric Electric Main Breaker Size (Residential only) Ell50 Amp or Less ❑ 200 Amp ❑Other I Value or Construction (including labor, material & profit) $ t -� rL� Description of Work: Pit __.1Q1•/n111ew fill t 'IS�ifU�y Pl�<Ti�LbY BE_�i 19 Contact 'Name & Phone#ofJOBSITE SUPERVISOR: &1tT ^ '� TA &rf� 10 S. bar tlrprtarJnfs: Electrical 5 6l(11i;i i Mechanical Qlf /iiilw Plumbing _1 Q� fhuTl�hliG/�490-fR.,' [fit, Framer Roofing Concrete Fireplacet/_.__. 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 b Form #s ordinan nd state laws regulating building construction. IA'rr I Applicant Signature f J/R _ Print Name I n , PhoneOZ _�L1It_LO L L— I. Distribution: - While -Office Yellow—ApplicantPink -WWW/Stormwaler q`-7O 7Z4t THIS APPLICATION EXPIRES 180 DAYS FROM AfPPLOCATIOM DATE city o$ /+-F®rt Collins 281 W. College Ave. o Fort Collins, CO 80524 o Phone: 970-416-2740 www.fcgov.com/building' BUDLONG PERMIT APPLOCATRON APPLICATION NUMBER 150 lb S 11 APPLICATION DATE 1 aI 3 i► s Job Site Address 750 ApomE :.ywy Unit # PROPERTY OWNER INF�Orr:__ (All owner information is required — it is not optional) Phone # "I t!.' I? ' ! ' I %.•i� Last name., i�;rNli;� _ First Name Middle r, Street Address_�45�j % lr , �` 1 ____ City—�L lry/' State / o _Zip �' Z01 CONTRACTOR INFO: Company Name U f• I' ,� iL r I+ury kyi� Contractor Phone # Q vl -1 . 5 Lic Holder Name �(I'iuV t pua City of Fort Collins License # " T _ Supervisor Cert #_ Mailing Address 17,0 lII[IONIh1i Nli/ _-_ city YU21 CxwkA State_ LEGAL INFO: + ?) I ' ' ' +t If r Filing # _-..,. ,.. Lot # -3 Block # 7 Lot Sq Ft- ._..!, . i(L ' Subdivision/PIJD +° is%;i:Y_.��J�;t+ 9 ._ CONSTRUCTION INFO: Total Building Sq Ft (not including basement)._ ,7U Total Garage Sq Ft Residential Sq FtComm'I Sq Ft # of Stories Bldg Height ,),> `,'% ___ # Dwelling Units + r 1167,11 2"d Floor S Ft.. L i 31" Floor S Ft )4L Unfrished Bsmt Sq Ft—.__ 1� Floor Ft eir, q q - —_— Finished Bsmt Sq Ft # of Bedrooms 1 It of Full Baths P _ % Baths '/Z Baths —,._...___ # of Fireplaces Air Conditioning: YesMNo� Energy info: ( Circle appropriate choice) 1. ComChec c / _ 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing LJ 6. Prescriptive w/ Blower Dolt 1 City of Fort Collins Stock Plan # List appropriate option UTILITIES INFO: r r Water Tap Size r, {, Sewer Tap Size G�, iff Metered: Yes n)� Nou Temp. Pedestal Yes❑ No ,/ Type of Heat: L1 Gas1-1 Electric Electric Main Breaker Size (Residential only) 0150 Amp or Less 11 200 Amp BOther 7,61 !!1(; Value or Construction (including labor, material & profit) $ Q!j'1, 110 1 Description of Work:- IJrlti-_Tllvlirl�lf GN1 l�lfu FR"71> by1� Illi' _— Contact Name & Phone # of JOBSITE SUPERVISOR: ` ��•� r I ,' `��—ZV- - 161 Subcontractor _t_nfo: I / II + Electrical _ E15 fl�!C� / __. Mechanical �1 Liii1�G'�T� Ildrii. Plumbingr(}� Framer_ Roofing r�U Concrete Fireplace i(/._ SolarI I{� 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 t)j l ort ,�.I +ris ordinanc nd state laws regulating building construction. Applicant Signature_g4 /1k .X4,, _._.... _ Print Name i Phone � 1 ' Distribution: White —Office Yellow --Applicant Pink —WWW/Slormwater q 7o Q-?2 7Z-(-Z- THUS APPLICATION LXPERES 180 DAYS FROM Al; PLOCATION9 DATE