HomeMy WebLinkAbout624 SMITH ST - APPLICATIONS - 6/30/2016Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
wvvw.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER Bvlp I3661 APPLICATION DATE
Job Site Address 624 Smith Street, Fort Collins 80524
Unit # NA
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # 970-222-8012
Last name Jansen First Name Seth Middle Alexander
Street Address 624 Smith Street city Fort Collins state CO zip 80524
CONTRACTOR INFO: Company Name owner contractin
Lic Holder Name
Mailing
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
_ City State Zip
LEGAL INFO:
Subdivision/PUD 10176 Filing # Lot # Block # 176 Lot Sq Ft 9500
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 522 Le"', ,O tZ/ Total Garage Sq Ft 0
Residential Sq Ft 522 dI- Comm'I Sq Ft 0 # of Stories I Bldg Height # Dwelling Units
1'Floor Sq Ft 522 2nd Floor Sq Ft 31d Floor Sq Ft Unfiished Bsmt Sq Ft _
Finished Bsmt Sq Ft 450 # of Bedrooms 2 # of Full Baths 2 % Baths '/2 Baths # of Fireplaces
Air Conditioning: Ye- No0 Energy into:( Circle appropriate choice) 9. 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 #
List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes []NoF� Temp. Pedestal Yes❑ No ❑
Type of Heat: ❑ Gas ❑Electric Electric Main Breaker Size (Residential only) 0150 Amp or Less ❑ 200 Amp DOther
Value of Construction (including labor, material & profit) $ r tot)
Description of Work:
Existing 230 square foot sunroom (closed in sun
ie # of JOBSITE
at east
square
Subcontractor Info:
Electrical ALR Electric (tentative) . Mechanical A -Team (tentative) Plumbing RPM (tentative)
Framer TBD
Solar NA
Roofing TBD
Other
Concrete TBD
Other
Fireplace NA
Other
Applicant: I hereby ackpVledge that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and C "Collin rdinances and state laws regulating building construction.
Applicant Signatur Print Name Seth Jansen Phone 970-222-8012
Distribution: White —Office Yellow —Applicant Pink—WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE