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HomeMy WebLinkAbout750 Jerome St - Applications/Garage - 12/04/2015e� 5 0� S4 �) cKyof r�q COMMUNOTY ©EVELr'OPfil9 ENT & NEIGHBORHOOD SERVOCES F®rt Coth 1s 281 ib. College Ave. o Fort Collins, CO 80524 v Phone- 570-416-2740 www.fcgou.com/building € UMD11Hr PER KY APPL6CNIT90M APPLICATION NUMBER.- O I/ APPLICATION DATE I l Job Site Address„ 75i; t)�1?D, r'` Unit # PROPERTY OWNER INFO:_ (All owner information is required — It is not optional) Phone # ' .` ..-l:'l /' j l � --- Last name_dkurL AL—_. First Name Middle Street Address Ns r t . v ��r(.. _ City f flia,li�j State _—Zip_._f GG CONTRACTOR INFO: Company Name 1ti1--__ v.i.h I i� f V �li Contractor Phone # A° �!' tl �-1�5..5 I1I I� Lic Holder Name A!'(City of Fort Collins License # _j�4� Supervisor Cert #__ 5,( p 'tfM Cf ' 1 U 1 State t/ Zi Mailing Address 7,(,r� . ,i�C.•Ja f � � _ tY�L�----- � P—�i;��u� LEGAL INFO: Subdivision/PUD I%i,� irli`itjl I`Jf�;j}� __ Filing Lot # Block# -LotSq Ft 1 in CONSTRUCTION INFO: Total Building Sq Ft (notincluding basement) _� 7 Total Garage Sq Ft t( Residential Sq Ft _ Comm'I Sq Ft ____ # of Stories_ Bldg Height�_#i Dwelling Units 1 °' Floor Sq Ft __ l :q 2W Floor Sq Ft Finished Bsmt Sq Ft _ It of Bedrooms 31d Floor Sq Ft Unfiished Bsmt Sq Ft —' # of Full Baths '/d Baths Y. Baths — # of Fireplaces - Air Conditioning: Ye�]No Energy info:( Circle appropriate choice) 1. f tC r2. ResCheck w/Air Sealing11 3, ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/lair Sealing LJ 6. Prescriptive w/ Blower Door City of Fort Collins Stock Plan # List appropriate option Its UTILITIES INFO: ' Water Tap Size _- .1 Sewer Tap Size [Il Ij _ Metered: Yes ;1 NoU Temp. Pedestal Yes No Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only) 1-1150 Amp or Less 11 200 Amp UOther Value of Construction (including labor, material & profit) $ Description of Work: I, J)_l' � I _.�t (. „ �tf y_ :7K { : �iul I iT >�_ ------ Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: �Cl 8ci �f Electrical— .Wi 1.g- Q-jLj V' Mechanical/P7llumkin g FramerT1�1� Roofing Itlu Concrete �t1�1 Fireplace-y 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 Ci46f For(,Co fins ordinances and state laws regulating building construction. Applicant Signature la Print Name tl r , tl.i� { } _ Phone - Ie ' Distribution: Whito--Office Yellow —Applicant Pink — WWW/Stormwater 'THIS AI,PP IICAii 20ll EXPIRES 180 DAYS FROW9 P PPLECA"L'110K 13AFTT Gr