HomeMy WebLinkAbout515 Coriander Ln - Applications/Single Family New - 12/01/2006BUILDING PERMITS &L INSPECTIONS DIVISION
J P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER �(/ Os�w APPLICATION DATE /a rl
Job Site Address of"6 1 ,01'j"� er Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # d'�%- 1500
Last Name tF yeiri"� - / First Name Ci r-044- n_ Middle �n-
Street Address ��'3� S, L-C3 i1eg6 City +�oy`% r�JI ills State C0 zip zos�)S
CONTRACTOR INFO: Company Name 4tYl�'tX 1l.r �d l°i�S Contractor Phone # Ito ` / $OD
Lic. Holder Nam +} GVC'rr� f I���lt BSI u[w�Vij d-e;S City of Fort Collins License # D-S6Supervisor Cert # SZ233
Mailing Address T"D•'6bX City 4;70.4 CIO)/ tYtS State 00 zip 005-;)a
LEGAL INFO: , l�
Subdivision/PUD �� bl)+'`� I C'Y Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION I`i(NNFO: Total Building Sq Ft (not including basement) Total Garage Sq, Ft 4
Residential Sq Ft Comm'I Sq Ft p # of Stories Bldg Height # Dwelling Units A \
1st Floor Sq Ft q32nd Floor Sq Ft D LI _ Unfinished Bsmt Sq Ft 730 Finished Bsmt Sq Ft e v
# of Bedrooms 3 # of Full Baths 1/4 Baths '/z Baths # of Fireplaces
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
�
3. ResCheck w/Blower Door l "-StT;7��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 ����11113 Sewer Tap Size 4 Metered: es or No Temp. Pedestal: &
or No
Type of Heat: q{LGas ❑ Electric Electric Main Breaker Size (Residential only): 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ �-� i 10
Description of Work: J 1 Vyl1e.. -F0Yr Jl' W0a `pi-04ne-Oyns�e't5w)
Contact Name & Phone # of JOBSITE SUPERVISOR:? W/ - jgv
Subcontractor Info:
Electrical "i1P5P-h� 0ee-tyC Mechanical N0f�VPdA.r-i� SFrr Plumbing �YCX ;nif'l 7T
Framer�1l{'l3Ph (tk1r�G�Nff7'� Roofing 0►rl/ ile �Vt; Concrete M IrrIG/Y- A. Wrdc 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 of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature Print Name L'i ���t'� f f Phone` A500
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE