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HomeMy WebLinkAbout817 JUTLAND LN - APPLICATIONS - 2/28/2017J COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 www.fcgov.com/building 3 3i(, f J BUILDING PERMIT APPLICATION ''(( `� APPLICATION NUMBER \� 1 7 v O 3 I APPLICATION DATE } Job Site Address �li7 7,AAc �ek U-% Q,-t-Coll.,, Sl Co 3(�924 Unit #, PROPERTY OWNER INFO: (All owner information is required- It is not optional) Phone # 3<7q-Sad-t�1�RS Last name 1Ea.� First Name -3 e.._'_Utk Middle 9-nc`.-, Street Address ail - I 5 , plc rcl I City T'r E cjl .5 State 63 Zip 9C) �,2.4 CONTRACTOR INFO: Company Name Contractor Phone Lic Holder Name N\A City of Fort Collins License # NA- Supervisor Cart # lJ A Mailing Address N& City is State tyPc Zip 1,11A LEGAL INFO: Subdivision/PUD .ITWR__ 06TY, Filing # Lot # Block # Lot Sq Ft �t� CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 2 y0r3 x*- kd o r)t Total Garage Sq Ft ?' Residential Sq Ft 'ZKh, Comm'I Sq Ft Nib # of Stories -Z Bldg Height # Dwelling Units KIPA 15' Floor Sq Ft 0,& a%tA 2nd Floor Sq Ft V2b 2%* 3`d Floor Sq Ft NK Unfiished Bsmt Sq Ft N is Finished Bsmt Sq Ft st.F4- # of Bedrooms Nk # of Full Baths NI l '/. Baths Nh '/z Baths 1Lk_ # of Fireplaces N-A Air Conditioning: e No Energy info: ( Circle appropriate choice) 1. Conrl 2. ResCheck w/Air Sealing 1�1A 3. ResCheck w/Blower Do r 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door City of Fort Collins Stock Plan # tm (k UTILITIES INFO: Water Tap Size t��t. Sewer Tap Size 2v a List appropriate option Metered: Yes or ID Temp. Pedestal Yes or Type of Heat: ❑ Gas �O Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less 14200 Amp ❑ Other Value of Construction (including labor, material R profit) $ 50 / 000 Description of Work: 2- %,-A%.. Zw%a- Contact Name 8 Phone # of JOBSITE SUPERVISOR: 'yc.Ct & &, 309-3q-1-1485 Subcontractor Info: Electrical NN Mechanical Plumbing f Framer �V\dt Roofing Mph Concrete Crr[�'..rr% C.v.c.fjr Fireplace Solar IyAr Other ILK Other �q(?r Other NIN 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 F Collins ordinances and state laws regulating building construction. pp � Applicant Signature Print Name -3 wx� 1)-": Phone �Ool^,�_ -1 Distribution: White — Office Yellow— Applicant Pink— WWW/Slormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE