HomeMy WebLinkAbout5703 Big Canyon Dr - Applications/Single Family New - 03/11/2013COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FortCollins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
1 2 /yf BUILDING PERMIT APPLICATION
-J APPLICATION NUMBER l cJD I I� 1 APPLICATION DATE — 1 gt - 13
Job Site Address �J��� l jo,, ak t,r-,\ 1�1 �lre . Unit #
PROPERTY `. � OWNER INFO: ((All owner information is required - it is not optional) Phone # 3Z - H � Ln - � �
Last name t-YO4 L C)d I-�1+-b�Cf-S� cs First Name (� t Middle p
Street Address (> A C(1 G , ` U `(� �� in rr^� l A U�l ity Q 4•QkfIW co 1 A State�_Zip OG l l, j
CONTRACTOR INFO: Company Name lG, (mod ,-1brr�,45 Contractor Phone # 21 (4
Lic Holder Name City of Fort Collins License #7 Supervisor Cert# 3 3_] y -b
Mailingc� I Address c�a,bL� � .�1n,1��.,rr•rin.l,� City Ci V 1C, State CCU Zip
LEGAL INFO:
Subdivision/PUD 4 \ e�l f (�(}t CY 115 l�`2e Filing # q� Lot #121— Block # I Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) ` O� Total Garage Sq Ft
Residential Sq Ft�� Comm'I Sq Ft _ # of Stories Bldg Heightas (1 e Dwelling Units
15'Floor Sq Ft 1 _c)-lOn 2ntl Floor Sq Ft 1 �c6 a 31 Floor Sq Ft Unfiished Bsmt Sq Ft C� Cb
Finished Bsmt Sq Ft jj _ # of Bedrooms # of Full Baths '/, Baths % Baths # of Fireplaces _
Air Conditioning: YeENoo Energy info:( Circle appropriate choice) 1. ComCheck 2. ResC heck w/Air Sealing
3. ResCheck w/Blower gDoor ❑4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Doom
City of Fort Collins Stock Plan #'_ �` I �J� List appropriate option #s 1 V1 11 I J�
UTILITIES INFO:
r� It it
Water Tap Size 3 'r'� Sewer Tap Size Metered: Yes allo[:1 Temp. Pedestal Yes® No
Type of Heat: ® Gas ❑Electric Electric Main Breaker Size (Residential only) W150 Amp or Les 2 n Other
Value of Construction (including labor, material & profit) $_ " I I � I
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrica'l/S4-n nrY'1Ct rV--, e-L -e.
Frameer�r K~LCdr,kr'ca1-� Roofing
Solar
& \0+a ( Other
Mechanical &CxS c:;- 4 a> Plumbing _) C � `tn nrw
AU= pct Concrete �rlSl cs�c,�2{1t Fireplace L a ci_e
Other
Other
Applicant: I hereby ac w ge that I have read th app ii; tion and stale that the above information is correct and agree to comply with all requirements
contained herein and ily of Fo Ca l' dinances d to laws regulating buiktin instruction. r11 ( �� rr��
Applicant Signature Print Nam _ ,, C 6_� Phon.3n-Lt%lfl' �bd�i
Distribution: te- ice Yellow -Applicant Pink - VWVW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE