HomeMy WebLinkAbout2227 Mackinac St - Applications/Single Family New - 05/09/2017For$ Collins
APPLICATION
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT
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APPLICATION
Job Site Address c9aaj MGClnr1q& c5t- Unit
TION
7
PROPERTY OWNER INFO: (All owner Information is required -it is not optional) Phone # 976- a �J4 — 3 D OO
Last name RA ►A C' nA
. First Name / Gt mt. _ Middle
Street address k Qs S• Hv w e s S-r-. 2Ah G . city
PLyt Cb) l tic � State zip �z�
CONTRACTOR INFO Company Name i a� Qe u et! W Me*-oi Contractor Phocn7e#
Lic Holder Name Kc nn r t N GLQ City of Fort Collins License #y—'ye A Supervisor Cert #._ 9
Mailing Address IRS 5- t�1i t>3 PJ S1- 2J City'NiIa i (I ✓I S State zip pv _2
LEGAL INFO: cI
Subdivision/PUD-Ze" %?f tA t n9., Filing # Lot # a Block #____L Lot Sq Ft U; � 34
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft 1,(o23 Comm'I Sq Ft # of StorlesBldg Height (r #Dwelling Units
1" Floor Sq Ft i oal 2n° Floor Sq Ft I 3t0 Floor Sq Ft Unfiished Bsmt Sq Ft 6
Finished Bsmt Sq Ft C— # of Bedrooms' # of Full Baths d, % Baths Q '/ Baths J_ # of Fireplaces 0
A/r Conditioning Ye ON Energy info.( Circle appropnate choice) 1. ComCheck 2 ResCheck w/Air Sealing
3 ResCheck w/Blower r 4 Simulated Performance Alternative[] 5 Prescriptive w/Air Sealing ❑ 6 Prescriptive w/ Blower D000
IreakCity of Fort Collins Stock Plan appropnate option #sorl!UTILITIES INFO:Water Tap Size Sewer Size Metered Yes�No Temp Pedestal YesEI No�Type of Heat171 GasElectncctnc Main Bize (Residential only) 1150 Amp or Less ❑ 200 Amp ❑Other
Value of Construction (including labor, material
Description of Work',
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor info:
Electrical A I � t a h c.e
Framer FAZ— Clr,wl ma$ Roofing I
Solar P Other_
ILA G'�S Plumbing
Fireplace P/A
Other
Applicant I hereby acknowledge that I have read this ipplication and state that the above I formation is correct and agree to comply with all requirements
contained herein and City of Fort Collins ordinances d state laws regulating building cons ction
ApplicantSicnature ( ,_o6,UdUa Print Name Ls�k Me'SnO/- Phone 170-61_0=21y0/
Distribution White -Office Yellow -Applicant Pink
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE