HomeMy WebLinkAbout2017 Stover St - Applications/Addition or Alteration - 02/23/2017City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER P� I-] O D M I APPLICATION DATE
Job Site Address a o � St U V c( Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone
Last name ffiy6f— First Name ILYL4% Middle
Street Address S�1"i d L�� City,r5ngT7 C-OLLAOS State__CO ZipICSIq
CONTRACTOR INFO: Company Name , � ��( � L32LS Contractor Phone # :7110 4SW WCOA
Lic Holder Name Kfyll.-e-A'�`y�ll� City of Fort Collins License # Supervisor Cert # 9 -S9Z
Mailing Address 11q 4-- EN*-AVN" ;1 City p6e-T COW-4 i') State " Zip o! -
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'I Sq
1S1 Floor Sq Ft
Finished Bsmt Sq Ft
2ntl Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3r1 Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths /z 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. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
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
Value of Construction (including labor, material & profit) $ Q( 8 (9 500
Description of Work: 2crPAtri- JENtc-'-c DAtAALw-' ¢.�4t-llcc ptt_ MAT�It-.AL-1
Of2—Tf112fiy LoirIR
Contact Name & Phone # of JOBSITE SUPERVISOR: j4Y„5 µE yC-tc- -7 Lo 03 f 2-1q9 1
Subcontractor Info: pn�_
Electrical ove.X �c�iIC ��.l�C dyw Mechanical
Framer Roofing
Solar Other
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 ::2Print Name -/Gyc-c Phone
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE