HomeMy WebLinkAbout750 Jerome St - Applications/Single Family New - 12/03/2015 (5)City of r COMMUNITY DEVELOPMENT & NEUGHBORN001) SERVICES
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e ®rt Collin S 281 K. College Ave. • Fort Collins, CO 80524 ^ Phone: 970-416-2740
—y www.fcgov.com/building
FAPPLICA71ON NUMBER f J I c6O 'Cps 19 APPLICATION DATE �-I 3
Job Site Address 750 dauriE V E( _ Unit # r
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PROPERTY OWNER INFO:. (All owner Information Is required - it Is not optional) Phone # 'I ,! Y 1 !'' 71 I'
Last name ( : Ua, First Namo Middle
Street Address AW-AL, _.. /city dl7 Stale�_Zip
CONTRACTOR O: Company Name �r n! �n1lGrtldr ri n� �flr Kt,i (S jPP _ Contractor Phone
L1C Holder Name 4("5....PQi�LI City of Fort Collins License # 11 Supervisor Cart
_J �' #
Moiling AddressCikfr( pWA6 StateCp/_Zip
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LEGAL INFO: M Z
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SubdivisloNPUD r, �OW'i•i I'Jd2 (r Filing # Lot #q_ Block #7 __. Lot Sq Ft_ .,G
CONSTRUCTION INFO: Total B iiding Sq Ft (not inrludina basament) i' ��n O Total Garage Sq F1' �'
1et 1'5_ �22' 11
Residential Sq Ft Comm'I Sq Ft — # of Stories._ .3 _ Bldg Height J7 "� _.. # Dwelling Units
1" Floor Sq R tom 2nd Floor Sq Ft i - 3i° Floor Sq Ft,.. _ Unfikshed Bsml Sq Ft
Finished Bsmt Sq Ft # of Bedrooms 3 # of Full Baths _ i % Baths '/a Baths I # of Fireplaces _.
Air Conditioning: Ye IN Energy info: ( Circle appropriate choice) 1.+Gewlack 2. ResCheck w/Atr Sealing2.L. A 1
3. ResCheck w/Blower Door �4. Simulated Porfermance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive
City of Fort Collins Stock Plan # List appropriate option #s
UJ(L"ITIES INFO:
Water Tap Size EYl%. Sewer Tap Size _ Metered: Yes ENE] Temp. Pedestal YesrZo IAA I
Type of Heat: NGas ` Electric Electric Main Breaker Size (Residential only) 150 Amp or Less ❑ 200 Amp ❑Other
Value of Construction (including labor. material & profit)
14
Description of Work: IFa1 IrilJA1Q,,.lE GIB �IS•r,6; (y Pfau U(T
Contact Name & Phone # of JOBSITE SUPERVISOR: 1 i t Oml — 7_3L— u ' o r
Subcontractor Info: -
Eledrical i (�C}�_ Mechanical illef Plumbing parawis, ¢ ar_IfUrr'_ Af_
.fin -•rim— 11 —Fireplace_
Framer _ I till Roofing I p� Concrete ThL _ lip___
Solar Other. _. Other Other _
Applicant: I hereby acknowledge that I have read this application and stale that the above information is correct and agree to comply with all requirements
contained herein and City .4f Fort • ns ordinanc nd stato laws regulating building construction. 'Se S ' L,atFq)-
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Applicant Signature !t Print Name 1 Phone �-7
t isbibution: White-Offioe Yellow -Applicant Pink -WWW/Stormwater 47�rp?z fZ(Z
THIS APPLICATION EXPIRES.180 DAYS FROM APPLLCATION DATE
C ity of
COMMUNITY DEVELOPMENT & NEDGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 o Phone: 970-416-2740
www.fcgov.com/building 6�07*
APPLICATION NUMBER_C APPLICATION DATE ! �'
Job Site Address 7,O Jami ;kTd __.__ Unit
PROPERTY OWNER INFO: _ (All owner information is required - it is not optional) Phone #___ rI/ j - i ?!%)
Last name_ I (ll� {, _ First Name Middle
Street Address_._ city
i #'• G___ State zip _ Z
11nir�r Ael��r�rtr:rirw( , r
CONTRACTOR INFO: Company Narne _ _ l?fP Contractor Phone #— "i��'.� /_
Lic Holder Name �(!i� '� _... J1Qji[r City of Fort Collins License #1' 1— Supervisor Cert #
Mailing Address_) 0'r __. I �� City Wrr -i 11JS State lift ___ 7_ip /�
LEGAL INFO:
Subdivision/PUD_ (It_ ^Jhi fr'liit(Y, Filing # Lot # �Block #=� Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) i„ ti�r� Total Garage Sq Ft
7 12i �
Residential Sq Ft 1{ `? �Comm'I Sq Ft -__......, # of Stories.7 _ Bldg Height .1. I_s #Dwelling Units
15' Floor Sq Ft r; 2n' Floor Sq Ft �7,ij 3"' Floor Sq Ft .. _ •� (G' Unfiished Bsmt Sq Ft
. s...
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths I '/ Baths '/2 Baths I # of Fireplaces—
Air Conditioning: YeNo Energy info: ( Circle appropriate choice) 1. i9erriQla$ck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door �4. Sirnulate8 Performance Alternative 5. Prescriptive w/Air Sealing 11 6. Prescri tive
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
Water Tap Size ,Xl f — p _ ,/ � /
Sewer Ta 5ize �� I ill Metered: Yes i� No Temp. Pedestal Yes No
Type of Heat: it Gas Electric Electric Main Breaker Size (Residential only) L- 150 Amp or Less 11 200 Amp DOther
Value of Construction (including labor, material & profit) $
Description of Work: 141rw Four-FourGfti OK,-� r& Po' nl-I v, _ 115 ,(lpO (,(l _
- f`r ,�� S
�7- 1T9 -
Contact Name & Phone # of JOBSITE SUPERVISOR: Y v r tri Iti
Subcontractor info:
Electrical /" i�IC�_, _. Mechanical (' z(a�N ___ Plumbing _��!UfS r'. � fI�n'ri.I �(�_
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Framer Roofing I C/U Concrete i7i,Fireplace -____
Solar_Other. __ Other Other__. _
Applicant: I hereby ackno%vledge 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.tlf Fort S4ojlins ordinanc and state laws regulating building construction. 2;-e5 5 P,— L4N-gr
Applicant Signature_ ' %Ai111f•,. -� _ Print Named*,r_ i.H1
.. i t Phone t
' istribution: White -OHice Yellow -Applicant Pink - WWW/Stormwater Vo6*72%2(Z
'ITC,11S APPILlICK dolt EXPIRES. 180 DAYS FIRGIA APP11,1CA.ii I10K DATE