HomeMy WebLinkAbout1500 W Lake St - Applications/Addition or Alteration - 10/12/2016Fr
` fCOMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
ort Collins281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
. wwwAcgov.com/building
BUILDING PERMIT APPLICATION
[APPLICATION NUMBER V "1 I APPLICATION DATE
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Job Site Address 1500 W Lake st Unit #�j
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # (? 701 � v / �Q V �J/ I5
Last name So O kro°�5 ,' 9First Name SOY) (Sfel, V Ax O��U��Middle
.[ Street AddressQ1 �� G� Q� Wa% City 1—i ' �011%1'n S State Zip'FOS 2
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CONTRACTOR INFO: Company Name Site Solutions Contractor Phone #970'218-3390
Lic Holder Name Brian Stephenson
Maiiing Address 519 N Overland Trail
LEGAL INFO:
Subdivision/PUD
City of Fort Collins License # 666
_ City FC State CO
Filing # Lot # Block #.
Supervisor Cert #
Zip80521
Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft_
111 Floor Sq Ft
Finished Bsmt Sq Ft
Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
2- Floor Sq Ft 3" Floor Sq Ft
# of Bedrooms # of Full Baths
% Baths
Unfiished Bsmt Sq Ft _
'/2 Baths # of Fireplaces
Air Conditioning: Ye�No❑ Energy info:( Circle appropriate choice) 1. ComCheck ❑ 2. ResCheck w/Air Sealing ❑
3. ResCheck wlBlower Door ❑ 4. Simulated Performance Alternative❑ 5. Prescriptive w/Air Sealing ❑ 6. Prescriptive w/ Blower Door[
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes ❑No❑ Temp. Pedestal YesE] No
Type of Heat: ❑; Gas ❑ Electric Electric Main Breaker Size (Residential only) 1:1150 Amp or Less ❑ 200 Amp ❑Other
Value of Construction (including labor, material & profit) $ 000. 00
Description of Work:
Install 2 4'x4' asement egress windows per IRG code and engineer letter
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer Roofing _
Solar Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge that I have read this application ands to -that the above information is correct and agree to comply with all requirements
contained herein and City of F Collins ord" ances and slat regulating building construction, p
Applicant Signature s Print Name;RWI^�LIW A/ fTJP0S Phone
Distribution: White —Office Yellow —Applicant Pink — WWWIStormwater
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