HomeMy WebLinkAbout5327 Cornerstone Dr - Applications/Addition or Alteration - 06/01/2007BUILDING 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
3 �? Co 2.n��E'ee-5 -M /L) E f
APPLICATION NUMBER �0 � e3 /`yV s— APPLICATION DATE
Job Site Address
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # .7 �� 7 :5
Last Name D' �t AO. First Name 'J' j1 Middle
Street Address 37d-6 Lo�^Qls�or.e City Tom" CD��in! State Zip
r rl (0 0-- C- %n
CONTRACTOR INFO: Company Name ilVoA-h rslc _op �u fG�L/r Contractor Phone #
Lic. Holder Name J can City of Fort Collins License # Supervisor Cert�i#
Mailing Address l ll � /If - S City U/1 "Id State GO Zip o6 L/?
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1 s' Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths 3/< Baths '/2 Baths # of Fireplaces _ �U
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing wF
4. E-Star w/Blower Door
Water Tap Size Sewer Tap Size
5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s VVV
Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 2
Description of Work: I Urki
I
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Contact Name & Phone # of JOBSITE SUPERVISOR: Se4.i1 &4'c
Subcontractor Info: 11
Electrical f-4 �6 (I� ne�o�o�� Mechanical
Framer
Roofing
Concrete
Plumbing
Other
�s ;
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 ollins ordinances and state laws regulating building construction.
Applicant Signature Print Name Sew /T�e" Phone r6) -o9/4/
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE