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HomeMy WebLinkAbout423 BUCKEYE ST - APPLICATIONS - 10/5/2018City of COMMUNITY 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 NUMBER1 �� APPLICATION DATE Job Site Address ga3 gi�� 2ye St Unit # PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 776- al i S'7o 6 Last name NnIAM ear First Name D nth 9� �- i�oi.` Middle Street Address "1 a.l % ��ye- � ((�� . City FOA U\ tw3 State Co zip CONTRACTOR INFO: Company Name +aivt5 6WS 1Vtac\ eaA Contractor Phone # 970-6 3 L 9D 31 n \ t� ` s ©-S7a Lic Holder Name 1`aY�mov�d E. 1'rYK�e�a�� City of Fort Collins License # Supervisor Cert #- 59q'A � Mailing Address HDl3 9"V%5AOVke. Or. City FOA CO\�t'�5 State Cam. zip g05j-5- LEGAL INFO: i Subdivision/PUD L.C. M e cr e,5 Ah1ke-,4 Filing # Lot # Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not including Residential Sq Ft "I 1 Comm'I Sq Ft 151 Floor Sq Ft Finished Bsmt Sq Ft Air Conditioning: Yes No 3. ResCheck w/Blower Door City of Fort Collins Stock Plan # UTILITIES INFO: 2nd Floor Sq Ft Total Garage Sq Ft # of Stories Bldg Height # Dwelling Units 3'd Floor Sq Ft Unfiished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/. Baths Yz 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) $ �A 6, 7 n of Work: elvho&e( Q \ 5\i �$IIK o a bow �voo�v� . Rk 'A-o %tet a:l /�i Al —Nes o PeAet Si,]I�s " a" r \ ' 1 s 4a ,.e ..Y:;-tr�:._._ �,e. ._,,.,.ALt.,�,�,.:w� �_.ue.,l,..v_ ,._:�}�,._-t-'la . I�,.4�t 11 a..11��_, A►c Contact Name & Phone # of JOBSITE SUPERVISOR: F. Ryv�►e.L1` 970-631 -CtU I Subcontractor Info: �+ ` Electrical I P-UJ :V.OV�t�e� �12c�vhL Mechanical &, oyy �eAev ttP���w�'���G Plumbing Framer ah Roofing Solar Other Concrete Other 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 C of Fort Collis ordinances an14 sttte laws regulating building construction. t� 1 Applicant Signature t tp VV\ct��r . Print Name �� ,dno E- I 1► M\eAAV- Phone"170-01-1o.31 v I Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE