HomeMy WebLinkAbout245 Dassault St - Applications/Addition or Alteration - 11/20/2017Ctty of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
,Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416-2740
wwwfcgay.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER , I l APPLICATION DATE 1 �' Z0' (+
Job Site Address 2`iS Z)msc,u14 St- Unit #
PROPERTY OWNER INFO: (All owner Information Is required - it is not optional) Phone #
Last name CAI "(#AA\1 �First Name Middle
Street Address 24 5j 1jGCS CL A (' 'JYtkT CIW' wk_ CJ It A S State C Q Zip o'�Lt
CONTRACTOR INFO Company Name »I�5 1bMRA`\ Contractor Phone # 120' 1 it 9S31�_
Lic Holder Name C4i d SSW iio fcx, City of Fort Collins License # Supervisor Carl #
Mailing Address '790 if- g16t4t-y- Aai City COA�(Mi11Gl State C0 Zip T)Irz-
Subdivision/PUD MUJ1�l�l Q -IDS Filing # Lot #4S Ob 3 Block # Lot Sq Ft
CONSTRUCTION INFO: Total Budding Sq Ft Ina including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stones Bldg Height # Dwelling Units _
10 Floor Sq Ft 2^d Floor Sq Ft 3nd Floor Sq Ft Unfiished Bsmt Sq Ft _
Finished Bsmt Sq Ft # of Bedrooms _ # of Full Baths 3/4 Baths 1/2 Baths # of Fireplaces
Air Conditioning YeGon Energy info ( Circle appropriate choice ) 1 ComCheck 1:1 2 ResCheck w/Air Sealing 11
3 ResCheck w/Blower Door a 4 Simulated Performance Alternative11 6 Prescnpbve w/Air Sealing 11 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 ❑Non Temp Pedestal Yes❑ No
Type of Heat Gas ❑Electric Electric Main Breaker Size (Residential only) Ell50 Amp or Less 11200 Amp ❑Other
Value of Construction (including labor, material 8 profit) $ ISO ,(iJy
Description of Work it�`L 1r�1GS>� YCCW�(_f1\�hU^ UV\ —r, I �ijt J i� Io4JuY�G�{�
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Contact Name 8 Phone # of JOBSITE SUPERVISOR: T>or� 7�-2U4— -(70 • 23 Z • tP Z?-q
Subcontractor Info: /
Electrical S C-"t Mechanical �aw� PlumbmgT%; Tpr✓✓1
Framer
Solar
Roofing
Other
Concrete
Other
Fireplace
Other
Applicant I hereby ackn ledge that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and C f Fort Collins ordinances and state laws regulating building construction
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Applicant Signature Print Name oU�l� Phone
Distribution White - Office Yellow -Applicant Pink -YWM/Stormwater
THIS- ALFULCIZA' EON [EXPIRES 481E DAYS FROM kPIPUCf1EW4 BATE