HomeMy WebLinkAbout3851 Cosmos Ln - Applications/Single Family New - 05/08/2007BUILDING PERMITS & INSPECTIONS DIVISION
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 AO APPLICATION DATE
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Job Site Address $,suffik`�'OSrUnit #
PROPERTY OWNER INFO: _,(AAll owner -
in ation is required - it is not optional) Phone O2-1-1\o�63
Last Name Tte-
k1X�lS-� _ • �First Name Middle
Street Address JDD 1�1'Y(lt A�(�0 City State
7 � ppZip �
CONTRACTOR INFO: Company NName✓✓U Contractlhcne #(_ )-7 1 l/1-O 1
Lic. Holder Nam t"ie I"(� ,V j 0LYI _ City of Fort Collins License # T Supervisor Cert #
Mailing Add
City
State
LEGAL INFO: ,' l j
Subdivision/PUD l l I ��' ��J Filing # r Lot # 2) h#p� Block # V Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) C �o P- Total Garage Sq Ft Lla,�
Residential Sq Ft Comm] Sq Ft # of Stories Bldg Heightt # Dwelling Units_
1st Floor Sq Ft ��� 2nd Floor Sq Ft Unfinished Bsmt Sq Ft_ Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths e 3/< Baths /z Baths # of Fireplaces
Air Conditioning: es No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4TE-tar Blower Door 5. Prescriptive w/Air Sealing �`6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # _ List appropriate option #s P �/ 7
UTILITIES INFO:
r"
Water Tap Size Sewer Tap Size 14 Metered es or No Temp. Pedestal: �T:)r No
Type of Heat: j as ❑ Electric Electric Main Breaker Size (Residential only):�50 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $C g ( S-to • 0
6 r
Description
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontra
r Info:
I
Mechanical
I
Ih �►{�q
D/(1�Qnyu �t / '` 40Plumbing L&
Electrical
C(1°J Lrn/�}�,�^^'^�1^
Frame
Roofing
YlyliUl tSt
Civr
l �'' Concrete L 12LQ I� Other Y
Applicant: I hereby acknowledge
that I qave read
this application and
state that the above information is correct and agree to comply with all requirements
contained herein
ndli
of,Fort
rdin
sand state laws regulating building construction.
Applicant Signature'
pColllinns
-�L
Print NamM
IWPhon�
Distribution:
White - Office
Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE