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HomeMy WebLinkAbout1939 Jessup Dr - Applications/Addition or Alteration - 03/31/2017City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES For t Collins 281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760 www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER 1 APPLICATION DATE CJob_Site_Adill ss 1 a34 .1f55c.tp pr- R , C©ll i n5 CD £0�AS Unit #. //O PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Last name (f cck �t6First Name Middle Street Address q(Oy R . N,OLIL City —State Co Zip 8b CONTRACTOR INFO�ICompany Name Contractor Phone # Lic Holder Name City of Fort Collins License # Supervisor Cent # Mailing Address City State Zip 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 'I Sq Ft ��i00 # of Stories Bldg Height # Dwelling Units Comm 1s' Floor Sq Ft Finished Bsmt Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft Unfiished 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. Prescriptive w/ Blower Door City of Fort Collins Stock Plan # UTILITIES INFO: Water Tap Size Sewer Tap Size List appropriate option #s 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 Construc__ tion (in�clludinggllabor, material 8 profit) $ / L Description of Work: N o 1 prUnif- W01c, ft?fc' Uecf , COSf11t° L 4iOJ t CI�CvhGp� y�Q �yOvti C� �(�KQ W Contact Name 8 Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical Framer Solar Roofing Other Mechanical Concrete Other Plumbing Fireplace Other Applicant: I hereby acknowledge tha r is ication and state that the above information is correct and agree to comply with all requirements contained herein and City of Fo in n s regulating building construction. /� / 6 Applicant -Signature !� Print Name \' "C h CA,m� Phone �'C09 77�0 Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE