HomeMy WebLinkAbout828 Prescott St - Applications/Deck - 05/24/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FortCollins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER V + `0 0 Z'q-8- Z APPLICATION DATE 5 - v H — 160
Job Site Address 'Loa --scoff T4- Unit #.
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 670'6/y
Last name 0First Name r eit .f7r r /— Middle
Street Address o� -k- r JV City rf �/%/U _ State /l Zip S'c)S-z
CONTRACTOR INFO: Company Name : 71�1y74 � jI_ Contractor Phone # 7% V-u - - J;'
Lic Holder Name GplL rvl / 1 City of Fort Collins License #7i4l Supervisor Cert # 35 2Z -0/
Mailing Address / %yLli� ,�f2, (�' 44 City /1/�'LQ State � Zip c5 Z
LEGAL INFO:
Subdivision/PUD �Jd'�✓7+'►% F nJ`/S Filing # / Lot #_ Block #--V— Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft 3 "i q Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
3rd Floor Sq Ft
Unfjished 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 #s
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) $ --71 & E &—' H 0
of
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
Fireplace
Solar Other [`jj,f 1 ' Kl�•+) 1O^D Other Other
blW c Y'x -0"
tbts Applicant: I hereby acknowledge that I have read app ication and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort ColljnsprdAnces and state laws regulating building construction.
Applicant Signature t Print Name ���`J Phone c ' (z-n-
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE