HomeMy WebLinkAbout3253 W Elizabeth St - Applications/Single Family New - 08/07/2014CG®6iilMlgN9TY f iE YEL®PMENT & NEIGHBORHOOD SERVICES
P®rt coils s 281 N. College Ave. a Fort Collins, CO 80524 o Phone: 970-416-2740 /
www.fcgov.com/building
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BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION
Job Site Address 170 I'� �. � Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #.
Last na
First Name Middle
Street Address �`\ City r—S7tatef- Zip
CONTRACTOR INFO: Company Name\ \t�(� , i-liiii lei') M-PS Contractor Phoon�e�#
Lic Holder Namet , YJynu �n�,���a City of Fort Collins License # �J`t (��,�Supervisor Cert #/�,` a�!-`�7
Mailing Address `'�S ' I 1 CiCO �Y-e City ��','1J�� State l� Zip -34OJ r
LEGAL INFO:
Subdivision/PUD - t, 1� Filing # \ Lot # �1 Block # Lot Sq Ft�' 1
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) ll/ �j l� Total Garage Sq Ft
I
Residential Sq Ft \ / 11 Comm'[ Sq. Ft # of Stories c� Bldg Height_ #Dwelling Units
I,' Floor Sq Ft \ 2"d Floor Sq Ft 3'd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 'D- % Baths '/ Baths , —# of Fireplaces
Air Conditioning:. YeYNon Energy info:( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4 imulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option #s1� rX)ue_ I
UTILITIES INFO: It - t it
Water Tap Size Sewer Tap Size_ Metered: Yes VNoD Temp. Pedestal Yes No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) �150 Amp or Less 200 Amp DiDther
(;/l ---• .7 '
Value of Construction (including labor, material & profit)
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontr ctor Info- OElectricalPI,
�����l -c Mechanical \ -e Gqj
Framer
Solar
Roofing
Other
Concrete
Other
PlumbingG-16 1 ai3 �l ,
FireplaceZL Lb C-saj' i t. e
Other
Applicant: I hereby acknowled e t I h e read this app ipation and state that the above information is correct and agree to comply with all requirements
contained herein and City of ns rdi antes a d state laws regulating building constructtiioon.1 \\r�y� `� 7 -7
Applicant Signature
. / Print Name ll�\ L��A \�i'1 �6 _ Phone �ZZ '� / 3772
Distribution: White - Office Yellow - Applicant Pink -WWW/Stormwater
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