HomeMy WebLinkAbout750 Jerome St - Applications/Garage - 12/03/2015 (2)F®rt Cothons
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COMMUNITY iI� ITY DEVELOPMENT & tHEIGHBORL4000 SERVICES,
281 W. College Ave. o Fort Collins, CO 80524 o Pfnonea 970-416-2740
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APPLICATION NUMBER��J v I
APPLICATION DATE
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Job Site r4ddress ---7 ter;., i �' , �� i Unit # r] ry
PROPERTY-OWNER.INFO: (All owner information is required — it is not optional) Phone # //j°l j.0 11.
Last name 111"Clill" 1� First Name / _ Middle
r l c + C i y 'f ' + Iio l --- State--- ,
Street Address �`I j7vEl'. , ITf F�.� City _ j'I" _ w...� —
CONTRACTOR INFO: Company Name fiNt,.J it; �i✓ tIT v i. Yh' �G119!n Contractor Phone 1�_# (�_ fir. /. / [y(�
Lic Holder Name (;� i�ls UGI�f� -_- City of Fort Collins License #-H__ Supervisor tC1.ert #
Mailing Address M-11 jYd 'fir (' I� 1 __ City rf 9'I (i����l;�J _ State (AL/' Zip__.;:;��
LEGAL INFO:
Subdivision/PUD 00 I 1! `it'+AJ k`bftj _ Filing # Lot # Block It Lot Sq Ft qq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft G Z
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Residential Sq Ft =_ Comm'I Sq Ft �~ # of Stories_ Bldg Height—# Dwelling Units -
1,' Floor Sq Ft 2 _ 2nd Floor Sq Ft "-` 31 Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft._.... It of Bedrooms # of Full Baths 3% Baths Yz Baths 11 of Fireplaces _
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Air Conditioning: Ye�Noo Energy info: ( circle appropriate choice ) 1. CornCheck M 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door LJ 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive %v/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
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Water Tap Size _�y�— Sewer Tap Size (jam_ Motored: Yes iNon Temp. Pedestal YesKI No Ix
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) n150 Amp or Less ❑ 200 Amp Other
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Value of Construction (including labor, material & profit) $ t'i. , I
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Description of Work:__.. __p �j 111 i ((L'n tL �!
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: q10—LZ2- C15P
Electrical _.L_I.tiZ"1GhMechanical Plumbing_ -
Framer I Roofing 'I1I Concrete Fireplace
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 gilins ordinances and state laws regulating building construction.
Applicant Signature �L4++ �/ Print NameL' 1A� t /I IL_— Phone + �L 5=
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i Distribution: White —Office Yellow —Applicant Pink—WWWlStormwater
THIS APPLICATION EXPIRES 180 DAYS FLuClM APPLUCK ION DATE