HomeMy WebLinkAbout315 Dassault St - Applications/Addition or Alteration - 11/20/2017cltvof COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
9F ` Collins 281 N. College Ave. - Fort Collins, CO 80524 - Phone: 970-416-2740
s vvwvicfagov com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE � t ZD n
Job Site Address 3 Il� ) C6�( u if S+ • Unit #
PROPERTY OWNER INFO. (All owner information is required- It Is not optional) Phone #
Last name Lai f 11� 1 First Name Middle
Street Address3lS SsC,L"(k `f' Clty� �oIII�S StateLj(j__Zip c1Sz
CONTRACTOR INFO Company Name �1 J1C Lf�fi �/1 Contractor Phone #_ZU
Lic Holder Name/�, � f� h tll nil( �(� City of Fort Collins License # z � Supervisor Certz,#
Mailing Address i['Ecl# ✓ �fit/t City. CPMi(Mh,'fl State�_Zip b)0-
SubdivisiontPUDftAAiA� qO Filing # Lot Block # Lot Sq Ft
CONSTRUCTION INFO: Total Budding Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stones Bldg Height # Dwelling Units
10 Floor Sq Ft 2nd Floor Sq Ft 31 Floor Sq Ft Unfiished Bsmt Sq Ft _
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3% Baths '% Baths # of Fireplaces
AlrConditloning. YeGon Energy Info ( Circle appropriate choice) 1 ComCheck 1] 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 #
List appropriate option
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered Yes ❑Nol] Temp Pedestal Yes❑ No
El
Type of Heat 0Gas []Electric Electric Main Breaker Size (Residential only) 1:1150 Amp or Less ❑ 200 Amp ❑Other
Value of Construction (including labor, material & profit) E_1.-�
0 } 0\u
Descn on of Work ___( �r�rk,._ . \1XJit --\" 6 ti I) I aVi S l7GFu^^/n� }
v\S'1l_g0bL4 , tom' +_C4-j la)y)Qh`) Ut^ erw - . P�'r_. SWX- a�- WWZe_.
C Y�Qr �ZO Contact Name & Phone # of JOBSITE SUPERVISOR. 23Z' �ZZ�
Subcontractor Info:
Electrical Gt
Framer
Solar
Roofing
Other
Mechanical q 5PA50/13 Plumbing--Yl-j __1
Concrete
Other
Fireplace
Other
Applicant I hereby acknow ge 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 o fon Collins ordinances and slate laws regulating buildin construction
/ i c p
Applicant Signature �- Print Nam a \ 1 Lll 1I0t Phone
Distribution White — Office Yellow— Applicant Pink — W W✓WStormwater
'CliI? Ad-211LI01_'I,I0K, 0"RIRES'eF® I1AYS' PRCrrtrek FtL10,A,710 K DATE