HomeMy WebLinkAbout6050 Medlar Pl - Applications/Addition or Alteration - 07/06/2018Fort of
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER C)1 (Z)V 5�k Ct mil' APPLICATION DATE
Job Site Address605O Medlar Place
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last nameCouch First NameMarVin
Street Address 6050 Medlar Place
CONTRACTOR INFO: Company Name Mata FlatWork
Lic Holder Name
Mailing Add
LEGALINFO:
Subdivision/PUDKechter Farms
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
151 Floor Sq Ft
2i° Floor Sq Ft
Unit #
Middle W.
City Fort Collins StateCO Zip80528
Contractor Phone #970-689-7815
City of Fort Collins License #.
City.
Filing # Lot #.
Supervisor Cert #
State Zip
Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/< Baths % Baths # of Fireplaces
Air conditioning: Yer✓ No0 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 W]NoF1 Temp. Pedestal Yes❑ No RI
Type of Heat: Fv1' Gas Electric Electric Main Breaker Size (Residential only) 0150 Amp or Less 11 200 Amp 0Other
Value of Construction (including labor, material & profit) $ -9008- 30DO
Description of Work:
Concrete patio, with underlying PVC conduit for electrical service to a hot tub and gas fire pit, and PVC conduit for a Flexible gas line to the fire pit.
Contact Name & Phone # of JOBSITE SUPERVISOR: M. Wayne Couch II 307.320.7075
Subcontractor Info:
Electrical A Better Electrician Mechanical
Framer Roofing
Solar Other
Plumbing Aggie Plumbing
Concrete Mata Flatwork
Other
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 ordinance land stat la egulating building construction.
Applicant Signatur�G r!/i ` Print Name ����(/T� �l���hone307, 3.�D, 1f%7S
Distribution: White — Office Yellow— Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE