HomeMy WebLinkAbout328 REMINGTON ST - APPLICATIONS - 8/8/2017City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
�t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT AP�PLI ATION
APPLICATION NUMBER I _70 � ✓ APPLICATION DATE 0/ tl
Job Site Address .:2G2f / 7W (Unit #��j/�
PROPERTY OWNERA ��` / 1 INFQ (AI wrier informatioq is required — it is not optional) Phone # Eo
A /� f / I
Last nameQW17WjViJ:7Aq AM,
WW First Name Middle
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Street Address d 7- OC i 1 !/ City !� State�Zip O�
CONTRACTOR INFO Company Name T �� f'L� Contractor Phone �g7, �7 5�
Lic Holder Name / City of Fort Collins License # Supervisor Cart ##
Mailing Address ,IIdWCk City IF:C-- State -Co Zip 3405Z-4z
LEGAL INFO:
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CONSTRUCTION INFO: Total Building Sq Ft (not including
Flung # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stones Bldg Height # Dwelling Units
1 sc Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
3" 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/Av Sealing 6 Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Water Tap Size Sewer Tap Size
List appropriate option
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) $
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Daennnhnn of Work 1A1S�Z1. /0 VGiJT l -1 i t'JLL , ON �/L 7 .LUrISi )II S bjj5 / u/-
Contact Name & Phone # of JOBSITE SUPERVISOR: '
SubcontractooyrInfo: Zaiz Q'T�`uzz%'
ElectricalTl.-, 0��� t�J((/(/ Mechanical
Framer
Solar
Roofing
Other
Concrete
Other
,A/ // // Y«+GlJ
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Plumbing
Fireplace
Other
Applicant I hereby acknowledge that I ave reao this a0pfication and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Coum
�is regulating building construction
Applicant Signature Print Name Phon Q ���/1 TJ l/
ODistribution White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE