HomeMy WebLinkAbout648 S COLLEGE AVE - APPLICATIONS - 7/1/2015M�lc� NcC_A rZ 7-A0 Y e ggnjkhWj 1)4z7NEa s Ce>Aj
City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER ICJ L) �I�� APPLICATION DATE �I ��l "� Z�r
Job Site Address &/ -s_ Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # A ? 2D ^ Z2 .6— ! z % 3
Last name 464p f x First Name.4/-� mAe� L Middle
Street Address ^2l% 2-�4-44 -S- , jj �,,� City ZCO f /G'G L� GState Ga -7Zip c��9
CONTRACTOR INFO: CompanyNameEIZi/Ll�IAWAI 6'V--'57-2vval�Contractor Phone # ! 70-26 /'�O L S-4
Lic Holder Name i / �10 �;� City of Fort Collins License #2� Supervisor Certi#, , ry
Mailing Address Le P%ZLG1__S14,,) JDZ_ CityF6'ZF 6e4LIl�State 6 ZipR_< _�/
LEGAL INFO:
Subdivision/PUD /y/ I Filing # Lot # Block # Lot Sq Ft
t
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft VIA
Residential Sq Ft Comm'I Sq Ft # of Stories Z Bldg Height # Dwelling Units
1" Floor Sq Ft 2ntl Floor Sq Ft 31 Floor Sq Ft � Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft N /�r # of Bedrooms # of Full Baths &A 3/< Baths � Yz Baths # of Fireplaces
Air Conditioning: es No 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:
Water Tap Size Sewer Tap Size
List appropriate option #s
Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp []Other
Value of Construction (including labor. material & profit)
Description of Work: `L�%��� G iZ�t 1%c�` ? f (,ll��y2�� syi2Vc=3 V -
Contact Name & Phone # of JOBSITE SUPERVISOR: Rle/c ffz4 C /ZQ 1 U— 72,69
Subcontractor Info: r
Electrical A echanical Q Plumbing
Framer R fing� �G / Concrete /�- Fireplace
Solar Other Ldi1G{ l%j Ga�2 Cam /fOther _ IL,!j l)GLG2 L __j_ Uther �f/ %J�P A/G�C/S
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 I'ns ordinances and state laws regulating building cc�o%nstruction..✓' g,J 6 7
Applicant Signature Print Name iUi /Vtf duF'I Phone `C6
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE