HomeMy WebLinkAbout425 THRASHER ST - APPLICATIONS - 7/3/2017City of
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Co lies 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1_J'' � 3(4 ` APPLICATION DATE C 1 -05— 1�
Job Site Address VZS -/'#ft#F-/L ST Unit #
PROPERTY OWNER INFO (All owner Information Is required - It Is not optional) Phone # VV - DO -
Last name & W First Name L*U( Middle
Street Address yZs 7-klffhTlL ST City Fo2T eoza'Nf State Go Zip 1?d5-Z4
CONTRACTOR INFO -Company Name
Lic Holder Name
Contractor Phone #
City of Fort Collins License # Supervisor Cart #
Mailing Address City
State
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
1a' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning Yes No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2n° Floor Sq Ft
# of Stones Bldg Height # Dwelling Units
310 Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths % Baths # of Fireplaces
Energy Info ( Circle appropriate choice ) 1 ComCheck 2 ResCheck w/Air Sealing
4 Simulated Performance Alternative 5 Prescriptive w/Air Sealing 6 Prescriptive w/ Blower Door
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) $ Z 00o
DescriptionofWork : 4 -ew/0, 0 �/�,d�..... rkrrc..� cam.-
7
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Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Into:
Electrical
Framer
Solar
Roofing
Other
Mechanical
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 of Fort Collins
%ordinances and state laws regulating building construction
Applicant Signature % Print Name 5uQQ 1)f_bI "Phone9-F0 - t/3o- SZZO
Distribution White - Office Yellow - Applicant Pink - W W W/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE