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HomeMy WebLinkAbout420 SMITH ST - APPLICATIONS - 5/30/2019City of Fort Collins COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740 www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER W tLl w vsf/`, APPLICATION DATE i Job Site Address420 Smith St Unit # PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # `7 70 —,20 7 ' o S6 -7 Last name PRAX� S PRopERT l ESQ GLC First Name Middle Street Address SWW to. QAy -4el ✓re, City 16V_27_ (10L6/lif State eU Zip CONTRACTOR INFO: Company Name Site Industries/ Basement Escape Contractor Phone #970-227-0789 Lic Holder Name Brian Stephenson City of Fort Collins License # 8i5 Supervisor Cert # Mailing Address 519 N Overland Trail cityFC State CO Zip80521 13ML>!©Yelp Subdivision/PUD Filing # Lot # Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not including Residential Sq Ft ls' Floor Sq Comm'I Sq 2nd Floor Sq Ft Total Garage Sq Ft # of Stories Bldg Height # Dwelling Units 3'd Floor Sq Ft Unfiished Bsmt Sq Ft Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths % Baths # of Fireplaces Air Conditioning: Ye�]Nou Energy info:( Circle appropriate choice) 1. ComCheck ❑ 2. ResCheck w/Air Sealing ❑ 3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternatives 5. Prescriptive w/Air Sealing ❑ 6. Prescriptive w/ Blower Door City of Fort Collins Stock Plan # List appropriate option Water Tap Size Sewer Tap Size Metered: Yes ❑No❑ Temp. Pedestal Yes[:] No ❑ Type of Heat: ❑ Gas Electric Electric Main Breaker Size (Residential only) 1-1150 Amp or Less ❑ 200 Amp DOther Value of Construction (including labor, material & profit) $ �; 7 7( JT Description Install 1 Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical Framer Solar Roofing Other Mechanical Concrete Other ng Plumbing Fireplace Other Applicant: I hereby acknowledge t I have read t " application and state that the above information is correct and agree to comply with all requirements contained herein and City of Fo ord" n and state laws regulating building construction. �! Applicant Signature Print Name '57eV6� COG gy Phone 970 a3/-3y9/ P2Ay.)s. PRoh�nT/�SK��C@Gr•Cp," Distribution: White —Office Yellow —Applicant Pink —WWW/Stormwater k*1L��( THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE