HomeMy WebLinkAbout351 Linden St - Applications/Other - 01/08/2018City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
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BUILDING PERMIT APPLICATION
APPLICATION NUMBER 18bb 1 o2 APPLICATION DATE
Job Site Address '�)a / 41 h
Unit # 16
PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone # -t 76 � —P r_r" / / r a�
Last name—4 W 3 S' � A /C First Name Middle M`/
Street Address -i S 1 4 i rt �1 e 40 � / (00 City F—6- State Zip �_ � 7
CONTRACTOR INFO Company Name G I Col h V4 Contractor Phone # 17 0-9 i 7 -289'd
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Lic Holder Name GeV 1 �� i, �✓l City of Fort
t^/ Collins License # W 92 Supervisor Cert #
Mailing Address 1l 56,�y"✓hl�l i ly �'� W City T' , � LI-1 State 9!::�o Zip v S 2
LEGAL INFO
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO Total Building Sq Ft (not including basement) - Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft \ # of Stones Bldg Height # Dwelling Units
1s' Floor Sq F
Fim ed Bsmt Sq Ft
Air Conditioning Yet. No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO
2nd Floor Sq Ft
311 Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/< Baths '/z Baths # of Fireplaces
Energy info ( Circle appropriate choice ) 1 ComCheck 2 ResCheck w/Air Sealing
4 Simulated Performance Alternative 5 Prescriptive w/Air Sealing 6 Prescriptive w/ Blower Door
List appropriate option
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
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Value of Construction (including labor, material & profit) $� OD
Description of Work �( O wpi 1
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Contact Name & Phone # of JOBSITE SUPERVISOR �jI q -2 0 % 17, 7 , a V
Subcontractor Info
Electrical
Framer Roofing
Solar Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
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 Fort Collins ordinances and state laws regulating building construction
Applicant Signature Print Name Phone
Distribution White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE