HomeMy WebLinkAbout619 CHERRY ST - APPLICATIONS - 10/7/2016F(_®""v cl COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
6etCollins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER Y `L/V lV O� APPLICATION DATEy /
Job Site Address. 01 G14E712'9"i
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # �bp su, L161'00
Last name b ICI wce'L'i (.'LL- First Name Middle
Street Address `10� V W1VVn C pa. , m ( 6 City F% 'Lr7 LvI'� State 60 Zip
CONTRACTOR INFO: Company Name 1��.v v2Y/3 Contractor Phone # "190 SSG 4900
Lic Holder Name k0046tJ SD►,iE 5 City of Fort Collins License # Supervisor Cert #
Mailing Address?�&)G� c.&ti S City�C �1-k--S State C-0 Zip 00s2y
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
15' Floor Sq Ft
Comm'I Sq
# of Stories Bldg Height # Dwelling Units
3'd Floor Sq Ft
Finished Bsmt Sq Ft 5 # of Bedrooms Z # of Full Baths t '/ Baths '/2 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:
2nd Floor Sq Ft
List appropriate option
Unfiished Bsmt Sq Ft 1 9i-!;-
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) $ 2�- I t-q 1W
Description of Work: t����^a ,✓�
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electricalle-6 �`L�G�� L Mechanical F1 60 1_Wj ,,S 14 O-A'71 -q 6- Plumbing 12-114 MC6H4i'v/C-rfL
Framer-f—e t, �09,4f,8 Roofing Concrete 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 of Fort oI ns ordi ances a state laws regulating building construction.
Applicant Signature Print Name ivl� Phone_` �� LieIL
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE