HomeMy WebLinkAbout368 Pascal St - Applications/Single Family New - 09/12/20170.1y or COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 s Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 11 / 1� (Y'D 1� APPLICATION DATE
Job Site Address 3 (016 ?G 5 C Q Unit #,
PROPERTY OWNER INFO: (All owner information is required - it is noT2 t optional) Phone # 7(> (O-1 a �-1 a l
Last name Laney— First Name U _sse _ Middle
Street Address :545- 1' CtSi City Ge-t" (^hkkiv s State Lb Zip
CONTRACTOR INFO: Company Name Fa_ L.P.Vn o Contractor
�Phone #
Lic Holder Name i Va reto &UCi - n City of Fort Collins License # lJ"�i� Supervisor Cert #� \
Mailing Address lay S_ ibWQB s'C. 2v.1 P. City �J"� CbULE State CO Zip ��z(
LEGAL INFO: r�
Subdivision/PUD OLO TW41) K)pe_y� Filing # Lot # ) Block # Lot Sq Ft,� $WU
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 451-7 Total Garage Sq Ft 9
9 1
Residential Sq Ft �_ Comm'I Sq Ft � # of Stories a+ Bldg Height a S-3 #Dwelling Units
151 Floor Sq Ft / 2�d Floor ScrJ q Ft 9 �3'd Floor Sq Ft Unflished Bsmt Sq Ft
UG # S
Finished Bsmt Sq Ft of Bedrooms � 1# of Full Baths �A/< Baths '/ Baths # of Fireplaces I
Air Conditioning: YeIANfl
Energy info: ( circle appropriate choice) 1. ComCheck11 2. ResCheck w/Air Sealing3. ResCheck w/Blower Door4. Simulated Performance Alternative❑5. Prescriptive w/Air Sealing6. P escriptive w/ Blower Doo
# S Q21 n, -''� !l
City of Fort Collins Stock Plan # 3 �f List appropriate option #� C— I n t <Ur a.� �n /vane � /`I �tiw.cf r€x�y�,
UTILITIES INFO: � 1 1
Water Tap Sizee-y Sewer Tap Size Metered: YesF'—C]Noll Temp. Pedestal Yes® No
Type of Heat: I VI Gas ❑Electric Electric Main Breaker Size (Residential only) 150 p or Less 200 Amp ❑Other
LEI / ` �1'�
Value of Construction (including labor, material & p,(ofit) $ . 0a off. 102 0
r
Description of Work: _ZIN
Contact Name & Phone # of JOBSITE SUPERVISOR: Yt f �� `O�
Subcontractor Info: p ►p1
Electrical �� < 1cr1/1 C2, Mechanical 4 ✓ �YUd (A Plumbing
Framer v.e Roofing iYi &VICCAA-S Concrete 3 C";'7 Ai, Fireplace (1J-YST-Wy)
Solar _GOther Other 6. Other G-
Applicant: I hereby acknowledge that I have read this application and slate that the above information is correct and agree to comply with all requirements
contained herein and City of ort Collins ordinances and state laws regulating building construction. �y
Applicant Signature �� jAh_) Print NameASA Mal/ Phone a�y-^2 —32flu
Distribution: White - Office Yellow -Applicant Pink -WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE