HomeMy WebLinkAbout240 Urban Prairie St - Applications/Single Family New - 08/15/2017 (5)City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N. College Ave. • Fort Colllnsq CO 80524 • Phane: 9706416-2740
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BUILDING PERMIT APPLICATION
APPLICATION NUMBER ✓ 1� v L O APPLICATION DATE
Job Site Address oC U�2%AdJ►e1G Unit # b[ele1
PROPERTY OWNER INFO:: (All owner Information Is required —it is not optional) Phone #
Last name First Name Middle
Street Address?Address?D IX, city DaA-L II.A sttate W zp `/a W 1 S'3
CONTRACTOR INFO Company Name t Gl 0 �ttn ( s �h aContractor Phone # -L-70 `2z-2 r'4�p 1�
Lic Holder Name ��rq 1) �-,�h ���+� r��I S City of Fort Collins License #. �4�_ Supervisor Certe#+ I O 6 t 6
Mailing Address I gig �L'J1:� Sn¢�.LL! CityT;C.* &111115 State_ Zip
Subdivision/PUD--UN M r LA1CX,, Filing # 2 Lot # 2C Block #__A�__ Lot Sq Ft v
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CONSTRUCTION INFO: Total Building Sq Ft (not including bawrnerrt) 2 Qb (p � �1T1o►tal Garage Sq Ft q �
Residential Sq Ft ?0 omm'I Sq Ft # of Stories- Bid- Heights y #Dwelling Units
1a Floor Sq Ft to 2n0 Floor Sq Ft -19 Z 31' Floor Sq Ft 818 Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms '7-_ # of Full Baths 3 % Baths % Baths j # of Fireplaces
Air Conditioning: Ye�No Energy info: ( Clyde appropriate g�hoi ) 1. ComCheck11 2. ResCheck w/Air Seating
11
3. ResChedk wBlower Door 4. Simulated Performance Aitemative�(l 5_ Prescriptive w/Air Sealing 11 S. Prescriptive w/ Blower Doia
City of Fort Collins Stock PlanL# 5 P n at 1 T_ List al,, r�p�pp" cute option #s
UTILITIES INFO:
1
Water Tap Size 31 it Sewer Tap Size l_ Metered: Yes NoEl Temp. Pedestal Yesz No ❑
Type of Heat: nGGas Electric Electric Main Breaker Size (Residential `o�nly)Q14150 Amp or Less ❑ 200 Amp ❑Other
Value of Construdio indudng�labo material &profit) $ 2-44 � � o
M
Contact Name & Phone* of J089171`E SUPERVISOR: M V a 47 1 — O of J
SubcontracttorrInto:
.f —'
Electrical (L C11G4eA4'eLL- Mechanical�C �F�Lt ��►t+e Plumbing ILI�.s
FramerTtAT 6LIlvnRoofing crate K Fireplace
Solar
Other
Other
Other
Applicant I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with ail requirements
contained herein and o Fort Collins ordinances and state laws regulating building construction. //'�`'
Applicant Signature PrintNameaI ftOf &6011i) Phone "V 4i l
5"1SB
Distrt on: White —Office Yellow —Applicant Pink —WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE