HomeMy WebLinkAbout3506 Kingston Cir - Applications/Garage - 07/09/2013COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. a Fort Collins, CO 80522-0580 a Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER J2 ` a�J Y � '' O APPLICATION DATE "I T49-713
Job Site Address j ! co (o r 2 Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # za - Z so - 9
Last name 4AC t..iC_1r1 First Name 71� it-. "t- Middle
Street Address -?SO to Ice r' , City E =a.� cj_(�,S State CO Zip 3y) 2-S
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
Mailing Add
LEGAL INFO:
City of Fort Collins License # Supervisor Cart #.
State Zip
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) I:10 0 Total Garage Sq Ft tJ
Residential Sq Ft Comm'I Sq Ft too-) # of Stories_ Bldg Height # Dwelling Units
1s' Floor Sq Ft _ti9"� 2nd Floor Sq Ft T 3rd Floor Sq Ft S'0-_3 Unfiished Bsmt Sq Ft 0 r
Finished Bsmt Sq Ft S-0 O # of Bedrooms 2 # of Full Baths Z 3/. Baths /z Baths # of Fireplaces
Air Conditioning: Yes iL'.`.J Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: [:]Gas lectric Electric Main Breaker Size (Residential only) 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ zp�y WW
Description of Work: �w2 . r �L�» /1, ✓� E-X -Z, .,, i 1.rL. 3/JC_ rk�
Czyq-L./ c.c - L9 ` /a /� o i . 2� ? w / S LV C_ 12 tya.-•_ $ rD✓ -", t
Contact Name &Phone # of JOBSITE SUPERVISOR: ch S 1-121 Gl r a -1,Ls - 7 f>D - Z v `6
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
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..
Applicant Signature Print Nameg,�7Sk 12 1 U-' u-*j Phone 3-2S7-&$c)-Z :�B
C// Distribution: hi -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE