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HomeMy WebLinkAbout112 Garfield St - Applications/Addition or Alteration - 06/16/2016city 0? Fort Collins COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER l!/ l J u APPLICATION DATE Job Site Address Unit # PROPERTY OWNER INFO: (All owner information is required - it is not optional) oppptiional))�Phone # / 7© `" �� / — 351149 Last name Rm=ux- First Name 1-n14e1 411 Middle Street Address 'Z'y'95, City y-pr State cCo Zip 41 CONTRACTOR INFO: C�om`�pany Nanme�� Awl ��-� �5' %� � ���� ���Contractor Phone # Lic Holder Name `1/ � J'gpf- City of Fort Collins License # Z 5- Supervisor Cert # � Z Mailing Address©Z��Z �� City State 4f7C2 Zip LEGAL INFO: Subdivision/PUD CONSTRUCTION INFO: Total Building Sq Ft (not including Residential Sq Ft 1st Floor Sq Ft Finished Bsmt Sq Ft Comm'I Sq 2nd Floor Sq Ft Filing # Lot # Block # Lot Sq Ft ement) Total Garage Sq Ft _ # of Stories Bldg Height # Dwelling Units 3rd Floor Sq Ft # of Bedrooms # of Full Baths % Baths Unfiished Bsmt Sq Ft _ '/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 r Type of Heat: $jGas ❑ Electric Electric Main Breaker Size (Residential only) Value of Construction (including labor, material & profit) $ C9a0 Description of Work: XlZ- X2- xy/—w /V/ lS��'✓G� j- Lll-d z k4l 441--A� G✓//?/ QGi� i�RAly is�/L Contact Name & Phone # of JOBSITE SUPERVISOR: MA R/r Subcontractor Info: // !�p� Electrical OAWg:/✓ Mechanical Plumbing I U'�J &I Framer Z=`%��� Roofing Solar Other Concrete Other No Temp. Pedestal Yes or No ❑ 150 Amp or Less ❑ 200 Amp ❑ Other 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 ordinance and state laws regulating building construction. Applicant Signature Print Name Phone 9 Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE