HomeMy WebLinkAbout2227 Yearling Dr - Applications/Duplex - 01/26/2017City of COMMUNITY DEVELOPMENT & NEIGHBOlZHOO& SERVICES
F®Y t Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
APPLICATION NU
Job Site Addre
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APPLICATION
Unit #
PROPERTY OWNER INFO: (All owner information ation is required it is not optional) Phone # ,. 2l rat
Last name �-I HQ rst ame/ �"�✓ Middle
Street Address T f City / • �� AS-t�attey (.� Zip —
CONTRACTOR P
CONTRACTOR INFO: Company Name i�/ Contractor Phone # `"/ 70 7 �� �-1 6 r
Lic Holder Name�y"("/'�% City of Fort Collins
�License
' #,,'b `s'30145 �Suupervisor Cert #�!
Mailing Address wtpo� a�`1�g✓ (i1� City �� ( 1e,1A> 'State i/o Zip P1 t
U
LEGAL INFO:
Subdivision/PUDIC/r& A, V,,3tjr �fj� Filing # �a Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (notincludingbasement) Total Garage Sq Ft ' I_��%_
Residential Sq F 4 I CZ-. Comm'I Sq Ft L./ # of Stories Bldg Height #Dwelling Units /+
1°' Floor Sq Ft ZO D 2ntl Floor Sq Ft (Y4_ 3rd Floor Sq Ft O Unfiished Bsmt Sq Ft D(''�
',hed Bsmt Sq Ft # of Bedrooms, # of Full Baths 2— '/, Baths_ _7Z, '/ Baths Z- #.of Fireplaces v
.)nditioning: Yet VINo Energy info: ( Circle appropriate choice ) 1. ComCheck11 2. ResCheck w/Air Sealing11
/
3. ResCheck w/Blower `Door 4. Simulated PerEofrpaytce Iternative❑ 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door.[
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO: £ ��
Water Tap Sizfffe���777tt1 �) Sewer Tap Size " Metered: Yes LAJNog Temp. Pedestal Yes IX No
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) 1:1150 Amp or Less //200 Amp 4Other
Value of Construction (including labor, material & profit) $
Description of
Contact Name & Phone # of JOBSITE SUPERVI
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Plumbing
Fireplace
Other Other
I
ant: I hereby acknowle that I have read, this application and state that the above information is correct and agree to comply with all requirements
c,......ined herein and City of Collins ordi nces and state laws regulating building cortsTuction. /��j]/�IF r �j� �j}�
Applicant Signature ~G Print Name / ►'V/� Phone_L?
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
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