HomeMy WebLinkAbout425 THRASHER ST - APPLICATIONS - 8/13/2015City of 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 ! S0 (0 b / 5 APPLICATION DATE
Job Site Address Nekj 4li, SI Unit #.
PROPERTY OWNER INFO: (All owner information is required - it is 7not optional) Phone # �� % - 3 �Z 8 y6� Last name d6j First Name G, f4✓✓t✓i.4 Middle dZACcl✓)
Street Address U mot.+ Lj 0. CityState CC,, Zip >✓tO
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Add
LEGAL INFO:
Contractor Phone #
City of Fort Collins License #_
City.
State
Supervisor Cert #,
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 1910 Total Garage Sq Ft �fp0
Residential Sq Ft
1s' Floor Sq Ft
Comm] Sq
2ntl Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
31 Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft F10 # of Bedrooms 3 # of Full Baths I 3/.� Baths 1 '/2 Baths # of Fireplaces
Air Conditioning: Yes 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:
List appropriate option #s
Water Tap Size Sewer Tap Size 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: lCtihn.(�(iC /3.5�..+., �- n,Oc.:/ ell' 024111k i�,?91 A,
tl\/II
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical '
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowled 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 o Collins ordinance and state laws regulating building construction. V
Applicant Signat:0Print Name Zrl4 A /21 . I/ Cc JPhone %/� 26-.2 a6
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE