HomeMy WebLinkAbout1213 Leawood St - Applications/Addition or Alteration - 01/13/200600
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Col ns BUILDING PERMIT APPLICATION
APPLICATION NUMBER O C; T APPLICATION DATE
Job Site Address i-)- i-:� L--PGt w o o a 5-t
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ' j-__)-_j
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Last Name V 1l�
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First Name Tao'`e• Middle
Street Address (Z l
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State W Zip j'
CONTRACTOR INFO:
Company Name
Contractor Phone #
Lic. Holder Name
City of Fort Collins License #
Supervisor Cert #
Mailing Address
City State
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Zip 1
LEGAL INFO:
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Subdivision/PUD .XJu'f
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f t l-$fFiling # 1� Lot # Block #
Lot Sq Ft i0 � . ,
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft 1p I D_ Comm] Sq Ft
1 st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes '&
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
_ Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths 3/4 Baths '/2 Baths
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
Water Tap Size Sewer Tap Size
# of Fireplaces \
2. ResCheck w/Air Sealing 1 ,�
6. Prescriptive w/Blower Door
List appropriate option #s �✓
Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: dGas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
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. ] i /
Applicant Signature', V Print Name ,�nL`. �Q V&w fka Phonet_A0D
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE