HomeMy WebLinkAbout908 Jerome St - Applications/Garage - 07/23/2018City of
Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
vvww fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE 7I X
Job Site AddresUnit
PROPERTY OWNER INFO: (All owner information is required - It Is not optional) Phone # -t //�o
Last name TtRzmL O P , L.L-L First Name Middle /
j
Street Address `�� I L n� C . 0 N-1C, City �d R-� State W Zip 2 2�-_
CONTRACTOR INFO: Company Nam o Pcti o�S c %� _ Contractor Phone # L6� ' u2 g1
Lic Holder Name Lpl City of Fort Collins
�License #��_ Supervisor Cert # 1_9 --6
Mailing Address L�� �` `Jp�ll L, �6' Clty: Q' 1 �611tL5 State- Zi&l^
LEGAL INFO:
Subdivision O. ®� MWY-N N0Q-4- Filing # Lot J � Block #�_ Lot Sq Ft �a
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
2"' Floor Sq Ft
31' Floor Sq
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths
% Baths
'/: Baths # of Fireplaces
Air Conditioning: Yes No
Energy info: ( Circle appropriate choice )
1. ComCheck
2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w//Air Sealing // 6. Pr crirpti�ve w/ Blower Door
List appropriate o tion #s 6 /J.E__ }� i �� T' 2 f-
City of Fort Collins Stock Plan # 5P �)�P
UTILITIES INFO:
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
Value of Construction (including labor, material & profit) $ d L �7/)-
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcont'rac�rr toInfo:
Electrical t ^`-t A-0 S [; —I CtA-f-Ace Mechanical /� Plumbing
Framer —oU Roofing �L pc�� Concrete A � �-CJ�G�c1 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 all requirements
contained herein and City off Fort Collins ordinances and state laws regulating building constructor.
me
Applicant Signature �-- Print Name GI ij Phone
Distributio . White -Office Yellow -Applicant Pink -WWW/Stonnwater
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