HomeMy WebLinkAbout2474 Ashland Ln - Applications/Single Family New - 05/14/2007City of Fort Collins
APPLICATION NUM
Job Site Address
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION DATE 5-1—q - 0
PROPERTY OWNER INFO: (All owner information is required - it is not optional)
r- �Ln First Name -
Unit # -
Phone # (q 760330pU
Middle
Last Name_ l)L-L t 17-1- r7pc4 1 /�
Street Address 7�J/ �)n'�i /#aU,U/ City ('� /�JState C C� Zip
CONTRACTORINFO:
Company Name r? . L tudt ! 1��+ � �C Contractor Phone # !! %G' � 30 ' �y
Lic. Holder Name 1s� L P%7/ L t d City of Fort Collins License # (� S7�/i Supervisor Cert
F� ` 1 a0 t� !#�? ) City ,ttE State C ! zip QiC-3
Mailing Address )/ .11� .�OF
LEGAL INFO:
Subdivision/PUD " CY L- Filing # / Lot # J Block #Lj�_ Lot Sq Ft
S Total Garage a �/)
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) C � %� L% g q Ft "�
Residential Sq Ft / 9 , Comm'I Sq Ft # of Stories Bldg Height e� #Dwelling Units
1s+ Floor Sq Ft 2nd Floor Sq Ft 7 Unfinished Bsmt Sq Ft LfX-y Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths C2 % Baths - '/z Baths - # of Fireplaces
Air Conditioning: Ye� No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4,E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # I ZS2 List appropriate option #s -„
UTILITIES INFO:
Water Tap Size 3!4 " Sewer Tap Size Metered: Yes ; r No Temp. Pedestal: Yes or No 1
Type of Heat: j�rGas ❑ Electric Electric Main Breaker Size (Residential only): X150 Amp or Less ❑ 200 Amp ❑ Other
vb "'
Value of Construction (including labor, material & profit) $ I%7
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR: l f �1/! s� LQd 7 7C' / -632-,-Oke'
Subcontractor Info:
Electrical; _ -t-t6/ l -G Mechanical S Dom/.,,' 4 U Plumbing �l�iJ
Framer �i> n Roofing � � %1 <� _ Concrete . } - C-, ., lj��ther
G
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 ort Collins ordinances and state laws regulating building construction. r� ^ -
Applicant Signature ` k Print Name 7SC1�ti�, 1d Sn, Phone
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE