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HomeMy WebLinkAbout704 Mathews St - Applications/Addition or Alteration - 01/08/2016i*t4fo�' COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES FFort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 www.fcgov.com/building u BUILDING PERMIT APPLICATION 11 APPLICATION NUMBER 000e)2- - APPLICATION DATE �� , ➢Vl d BRA Job Site Address. 70 4( Koc+ Unit # PROPERTY OWNER INFO:: (All owner information is required -it is not optional) Phone #�t1 Last nameA-A+e I�S©Vl First Name �r� Middle A &L-1 Street Address / o� tl_�GLt-G el�15 City �-r^J ��I�S State �� Zipa� CONTRACTOR' INFO: Company Name �I DU> tLft- W AO ux�r� Contractor Phone # Lic Holder Name Mailing Address_ LEGAL INFO: Subdivision/PUD City of Fort Collins License # Supervisor Cert # City Filing # Lot # State Zip Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft Residential Sq Ft Comm'I Sq Ft — 'Is' Floor Sq Ft 2nd Floor Sq Ft # of Stories Bldg Height 3rd Floor Sq Ft # Dwelling Units Unfiished Bsmt Sq Ft Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door City of Fort Collins Stock Plan # UTILITIES INFO: List appropriate option Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other Value of Construction (including labor, material & profit) $ lino© 1 Description of Work: S ej'to Lj&;e)o 1", Contact Name & Phone # of JOBSITE SUPERVISOR: :.Subcontractor Info: Electrical SC.—lL--Q Mechanical Framer Solar Roofing Other Concrete Other Plumbing Fireplace 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 Collins rdinances and state laws regulating building construction. �j �% Applicant Signature . 0�w4°71 L Print Name U"af L A Ai tG':c/wt, Phone zaq— ZBzi Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE