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HomeMy WebLinkAbout1418 ASH DR - APPLICATIONS - 6/9/2017COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES Fort Collins APPLICATION Job Site Address 1 4 ( 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION DATE Unit # PROPERTY OWNER INFO, (All owner Information Is required - It Is''not __optionnal"I) Phone # o 09 - (loco 36m Last name - L1 First Name IF/fr /� Middle L Street Address IAI6 ik�rl S(LCC�Ir City Ed 101161S State__CD__zlp 90521 CONTRACTOR INFO __C__o__m__pany Name (� rlex 1 (1U( oyy Contractor Phone # Lic Holder Name 111 City of Fort Collins License # Supervisor Cart # Mailing Address City State LEGAL INFO. Subdivision/PUD Filing # Lot #. CONSTRUCTION INFO, Total Building Sq Ft (not including Residential Sq Ft 3 I DO Comm'I Sq Ft 151 Floor Sq Ft Finished Bsmt Sq Ft 2"d Floor Sq Ft Block # Lot Sq Ft Total Garage Sq Ft # of Stories Bldg Height # Dwelling Units 3nd Floor Sq Ft Unfiished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/z Baths # of Fireplaces Air Conditioning Yes ©o 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 # 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 BreakerSize(Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other Value of Construction (including labor, material &`profit) $ Description of Work r'AMP lD" Ol Ml� �grJ�J��/3&2� Q11d 9w4 _r4m -e-- MrieD. hnAnr�w,... �Mnro�rni� .ti, .i 7,nA -Piemr ("vas►, +n (1v,vn +n rRrio_ w ti - (,� 4+T Contact Nam' & Phone # of JOBSITE SUPERVISOR - Subcontractor ,IInfo* Jbt�SCAOP(W%10�1.CGYt1, }y`�-, Electrical Veto � Mechanical I Plum1binr� LtK1s f� °3 w W hi1W a,fn'oOl�i,e. Framer oofing • C Concrete FireplAce Solar Other Other Other Applicant I hereby acknowledge that I have read this contained herein and Ctht ;LEortfColkfSs�rdinances a Applicant ipplication and state that the above information is correct and agree to comply with all requirements d state laws regulating building construction Print Name3kgjkA Pj RWIPhone i /° White — Office Yellow —Applicant Pink — W W W/Stornwater APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE