HomeMy WebLinkAbout625 ARMSTRONG AVE - APPLICATIONS - 9/12/2016COMMUNITY 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 NUMBER APPLICATION APPLICATION DATE 9h2h (p
Job Site Address Av' Z 'r3 � `'° `�� r df► /s`.-e' Unit #
fe _r CVI l S a
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 1 '—'3 -7 1 1
' 1
Last name �� I First Name r-%j Middle
Street Address l® City Y4 6� 7 111'15 S�
^tate, Zip
CONTRACTOR INFO: Compa{n-y�Name-J ��� Utf.,Contractor Phone #1 p ---2 GA72
Lic Holder Name Jew Y/i�.ea 12 City of Fort Collins License D � 1 4� Supervisor Cert # �S
Mailing Address �� � e'� City ii=11,*C-CAd IYV� State (-0 Zip s
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft
Is1 Floor Sq Ft
Finished Bsmt Sq Ft
Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # 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 #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) $ 4QV%e54-e�
Description of Works
Contact Name & Phone # of JOBSITE SUPERVISOR: ��� r uT;? Z
Subcontractor Info:
Electrical �� Mechanical l Plumbing
Framer i Roofing kok4� Concrete �-)p Fireplace
Solar
Other
Other
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 Cit Collins ordina es and state laws regulating building constructi n.
Applicant Signature' Print Name. � W 16 Phone2? ,ZZ
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE