HomeMy WebLinkAbout825 Laporte Ave - Applications/Addition or Alteration - 10/12/2018City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
:Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
/ wvn%fegov com/bullding
7�BUILDING PERMIT APPLICATION
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APPLICATION NUMBER V Iy V APPLICATION DATE
Job Site Address %a5 LZLpQC--Ve t{�y� �{• Colli►�� (Rj�"`
PROPERTY }OW.,NER INFO: (All owner Information Is required - it Is(V not
-optional) Phone #
W�J�`55 11D 1
Last name QCK First Name VL S r� Middle S • /� i
Street Address�a q4 \ T f\V'f'e �C cki e S b7 , City Po -i Ey Wcd�S State l�(7 --Zip %C6 coo
CONTRACTOR INFO: Company Named CSC D b GV d e c4n Contractor Phone # Orl()"3l `t— bS5(y
Lic Holder Name n ci!/ City of Fort Collins License # Supervisor Cart #
Mailing Address (Pa(.erJ &LtV %k !�� D b City •CA Li CAS State CO' Zip �lS 0
LEGAL INFO: �i 1 5 k t..(LL
Subdivision/PUD corn1 S Filing # Lot It a Block # aau Lot Sq Ft 'I D D
CONSTRUCTION INFO: Total Building Sq Ft (not Including basement)_
Total Garage Sq Ft
Residential Sq Ft Comml Sq Ft f)OL # of Stories a Bldg Height Td/1 # Dwelling Units %
1" Floor Sq Ft, 2n0 Floor Sq Ft 31' Floor Sq Ft rnt 0. Unfiished Bsmt Sq Ft ' h to,
Finished Bsmt Sq Ft n I A, # of Bedroom: _ - # of Full Baths _ % Baths '/: Baths C7 # of Fireplaces
Air Conditioning: Ye�& Energy Info: (Circle appropriate choice) 1.ComCheck11 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Altemativen 5. Prescriptive w/Air Sealing a 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
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Water Tap Size 3 4 Sewer Tap Size q 1 V%c.h Metered: Yes FNol:l Temp. Pedestal Yes❑ No ❑
Type of Heat: a Gas ❑Electric Electric Main Breaker Size (Residential only) 0150 Amp or Less ❑ 200 Amp Other
Value of Construction (including labor, material & profit) $ 9 4M
Description of
k, "_v�_{toI. ^1'�`h
of JOBSITE SUPERVISOR: CICDb Cc�, t 'b'�61 Coo
Subcontmcttor Info: �y
Electrical lstt kel tia Mechanical9t. 4-ew l TI Plumbing Pv-uf LLrAbinq
Framer
Solar
Roofing k0 b Concrete FFIDVAf V%0L !n&- FT QIace
13
Other
Other
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. f .,
Applicant Signature Print Name _ iTV7S W0.y (� Phone 5 W -JS `4 A(0`4:-
Distribution: White -Office Yellow -Applicant Pink -WWW/Stormwater
THIIS APPLUCA790[M EXPORES 180 DAYS FROM APP9.9(CATIOM DATE