HomeMy WebLinkAbout621 REMINGTON ST - APPLICATIONS - 11/7/2019City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER V APPLICATION DATE /v /
Job Site Address G2-S Vkxntf\gkor\ Unitka
# \ 12
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 303 S112 bos-t
Last name l nw, RZMtf�A�ot\, L\--G First Name `!1\'C.tl 6f o ��InAAV\Qj Middle
Street Address \384U `�i\V,f�;e\� �+� - City *&60 R 42 State Co zip RU�?3
CONTRACTOR INFO: Company Name \"� � 0, Contractor Phone #
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
City of Fort Collins License # Supervisor Cart #.
City.
State
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft 3_ 2� Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1 s' Floor Sq Ft
2nd Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished 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/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
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 � El200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ O 100 0 + h�a'e
Description of Work: •&'p\Q,(CG, CO��\0. beCl�^S 0(\ �XtS�t nc� pOtL� 5�(�c,\\xe,• \VO (\mil (AC(,�\
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
�co f`(10;f a —'2M Sys (=�o5q
P 01of �) Vj-)90 .cco'
Plumbing
Concrete Fireplace
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 City f Fort C Ili ordinances and state laws regulating building construction. 22 �1 / /1c C�
Applicant Signature_ /�l Print Name f 016 �\ Phone3�J-1� bV J 1
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE