HomeMy WebLinkAbout615 E PLUM ST - APPLICATIONS - 8/26/2015Cidyo®f COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ � www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBERc� U APPLICATION DATE :942LP- /-//
Job Site Address 6 - f (Lv Unit #
PROPERTY OWNER INFO: (All owner information
is required — it is not optional) Phone #
Last name 1.Pritt.�Z(4first Name ,� Middle
Street Address�f j J �/�%� City Y / L1TLU�tif State (� Zip J of
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name ("/UU-1 CC jl-�' City of Fort Collins License # Supervisor Cert # -
Mailing Address/ / 4342W City ), State Zip Q �J
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq Ft.
15' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
# of Bedrooms
Filing # Lot # Block # Lot Sq Ft
ement) Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units _
3rd Floor Sq Ft Unfiished Bsmt Sq Ft _
# of Full Baths % Baths '/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
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Sizel (Residential only) ❑ 150 Amp or Less ❑ 200 Amp [:]Other
Value of Construction (including labor, material & profit) $ r�1 1 -` � ,
Description of Work: 13ui. I�JGa D.,r��.� o/ ( x LQ — ` A
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical
Framer J4)C.O Roofing
Solar
Other
Concrete
Other
Plumbing
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 aKcLr Collins rd' 7
anc s d sta laws regulating building construction. %r /G+
Applicant Signature —t* Print Name r* ij @C /l Phone oyf � �"iTQ Q P
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE