HomeMy WebLinkAbout108 E Lincoln Ave - Applications/Addition or Alteration - 02/06/2018City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER�I '� APPLICATION DATE
Job Site Address toe) Ll NcOi✓N %Y'C" Unit #.
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # C, 4 S /
a-e Z_ y r 0pe V171-es C-L, C-
Last nameLFirst Name (K ���� Middle Q
Street Address I'k, �T ! ��City State zipy 0 ss o
CONTRACTOR INFO- Company Name kyn Ase l/l CDAt. VLA(-� i�1 Contractor Phone # c� 7,0 3� 7 9 s2 j �
JJ �
Lic Holder Name S1n� -AIn�M U (--C44 1 City of Fort Collins License # r) 3 Supervisor Cert # o
Mailing Address�� � c0 Jr " `'Ayy C7 City CTV e State C_ d zip
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Filing #,
Residential Sq Ft 1 5( Comm'I Sq Ft # of Stories
15S Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
Lot # Block # Lot Sq Ft
Total Garage Sq Ft
Bldg Height # Dwelling Units
3rd Floor Sq Ft
# of Bedrooms # of Full Baths % Baths
Unfiished Bsmt Sq Ft
'/2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1 ComCheck 2 ResCheck w/Air Sealing 4L
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door*-cd
City of Fort Collins Stock Plan #
UTILITIES INFO:
Water Tap Size
Type of Heat: � Gas
Sewer Tap Size
[Electric
List appropriate option #s nr
�I
Metered: Yes or No Temp Pedestal Yes or No I
Q
Electric Main Breaker Size (Residential only) � 150 Amp or Less ❑ 200 Amp [:]Other N
6"
Value of Construction (including labor, material & profit)
Subcontractor Info:
$ t2l,�Psv
Electrical` 1) e 1.eU ►' ( (Aj Mechanical � � 9 T( 1/ !,
Framer
Solar
Roofing A-,V i PlWl c&O Concrete
Other
Other
f I '-
Plumbing 6-ow'p-t ` 1 c�n�6i�r�
Fireplace
Other
Applicant I hereby acknowle a th I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein nd City o ort C lins ordinances and state laws regulating building construction �� _ � 1 y
Applicant Sign ture Print Name 1 ��� ��lClr-��(( Phoneb� f�U �� I
Distribution White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE