HomeMy WebLinkAbout3324 S Lemay Ave - Applications/Addition or Alteration - 05/23/2016Qty of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rt Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building -#4cf
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1 00,;t '139 APPLICATION DATE -6/a3 lip
Job Site Address , �,3-24 j, ,e � �, AX2 , Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name I A Y - (JCL t [4 Q E- First Name _JA RA lA Middle
Street Address 3,324 , - l_ /JJ � City - t o I N S State Zip
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address
LEGAL INFO:
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
State Zip
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft 13 Comm'I Sq Ft # of Stories 2 Bldg Height
1s' Floor Sq Ft o2a2.Ci 2nd Floor Sq Ft /3 93 3rd Floor Sq Ft
# Dwelling Units
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft `yA # of Bedrooms I # of Full Baths I_ % Baths '/2 Baths # of Fireplaces
Air Conditioning: Ye�]Non Energy info:( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 11
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 []No[] Temp. Pedestal Yes❑ No ❑
Type of Heat: a Gas Electric Electric Main Breaker Size (Residential only) �150 Amp or Less1:1 200 Amp Other
Value of Construction (including labor, material & profit) $ ?6; 000
Description of We
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Contact Name & Phone # of JOBSITE SUPERVISOR: SAiLA P U - r -f i 710 976 -
Subcontractor Info: /,,2pp"e, Iti a()
Electrical 1�a,x., Mechanical Plumbing %
Framer -✓ / 15?04 o�g /jej 62p,rno�W, Concrete !/3. - Fireplace
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 City of F Collins ordin c,s :�,d�!,,tate aws regulating building construction.]jApplicant Signature —Print Name jQY F� Ni14 ,��n�U� Phone Yx0
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
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