HomeMy WebLinkAbout1852 Crestmore Pl - Applications/Garage - 11/17/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER ✓ I Vl/ U 611 APPLICATION
Job Site Address
/ >? 4? r- < P
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # c>? D 7— S-7 ® -* V 97
Last name 4. eT Py r-n etc First Name 1�4;, 7c4 Vtc-� Middle 0 4 j
Street Address 7 V l @/ 1. K2 Ski( City Tof I G8/din I State G 0 Zip ,SAS'
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
Contractor Phone #
City of Fort Collins License # Supervisor Cert #_
_ City State Zip_
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft ��S Comm'I Sq Ft # of Stories r Bldg Height 8 # Dwelling Units
15' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes D
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
201 Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths /2 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 #s.
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) ❑ 1150 Amp or Less E1 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ �, V VV I U , -ILA '/L "J
Description of Work: i d f a Y aJ A r*,4 er-✓� 6 r ]C jf r fL, (¢ /7 (' <<i r
Contact Name & Phone # of JOBSITE SUPERVISOR: y4elick?'"I' LGI A--"�7 er ci d,07 5S7 G /Y9 7
Subcontractor Info:
Electrical
Framer
Solar
Roofing
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 or an state laws regulating building construction. ,,
Applicant Signature L" Print Name AlLCekv L4Vt r;-vrt--Phone;o.7-476 1 y97
Distribution: White — Office Yellow,,— Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE