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HomeMy WebLinkAbout418 Lyons St - Applications/Addition or Alteration - 07/11/2016City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 wAm.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER J�J r� -I tl / APPLICATION DATE I I - i Job Site Address Ll � d L-yo 7S Unit # PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # 9 _Vj TSU ^1 � 3 f Last name (N-\ First Name N \L-�--AH �- YOKfQ Middle Street Address \2C.+�VIC—,�7 T L City %I )i EOLL1rJS State CO Zip Sa� CONTRACTOR INFO: Company Name _'� Aa oc,_nAEl-s Contractor Phone #_ Lic Holder Name Mailing Address LEGAL INFO: City of Fort Collins License # Supervisor Cert # State Zip Subdivision/PUD Filing # Lofty# / Block # Lot Sq Ft CONSTRUCTION INFO: Total � �BBuilding Sq Ft (not including basem) entr- " I 7�l!/ Total Garage Sq Ft Residential Sq Ft VComm'I Sq Ft v / # of Stories Bldg Height # Dwelling Units 1'Floor Sq Ft b7"' Floor Sq Ft � atom 3rd Floor Sq Ft Unfiished Bsmt Sq Ft Finished Bsmt Sq Ft ,WW # of Bedrooms # of Full Baths v, '/< Baths /z Baths # of Fireplaces Air Conditioning: Yes(_Q 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 # List appropriate option UTILITIES INFO: 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 R 01f r \ r�-0OR- Value of Construction (including labor, material 8 profit) $�©. of Contact Name 8 Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical Framer Solar Roofing Other Mechanical Concrete Other Plumbing Fireplace Other lria 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 Ili r nces and state laws regulating building construction. M q Applicant Signature Print Name H ic.&.,�nz., l "' �� 1 Phone / c96'(7�L3� Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE