HomeMy WebLinkAbout7502 Gold Hill Ct - Applications/Addition or Alteration - 09/03/2013APPLICATION NUMBER-??( ✓ LI-'. APPLICATION DATE Q/ 3 //
Job Site Address 'l-I Sd Z 6-ow v ; 11 'CT 'E Unit #
PROPERTY OWNER INFO: '(All owner information is required -it is not optional) Phone #
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Last nameu�Tl1�. First Name F-�tltr-T �'� Middle
Street Address' '] 302y G-01d M11' Cj City_ E2- 4i A p j State'-_"4f 0 Zip ox-
CONTRACTOR'INFO: Company Name Contrac4ocPhone #
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Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip ',
LEGAL INFO:
Subdivision/PUD `; Filing # Lot # Block # Lot Sq Ft
C01NSTRU6710N INFO: TotaJ`Building Sq Ft i oi;r r townie ). Total Garage!Sq Ft
Residential SqFt .L 00 Cbmmxl Sq Ft J1 # of Stories Bldg Height t # Dwelling Units
• 1" Floor Sq Ft -'I 4 S O• 2nd Floor Sq Ft - So 0 3m Floor Sq Ft . A' Unfiished Bsmt.Sq Ft
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FJDished Bsmt Sq Ft # of Bedroorris; # of Full Baths _ '/. Baths _� /z Ba[hs_ # of Fireplaces
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Condiiionidg Ye
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6rergy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCfieck w/Air Sealing41
3. ResCheck w/Blower Door
4. Simulated Performance Aitemat e 5: Prescriptive w/Air SealiggEl 6 Prescriptive vi! Blower:Door�
City of, Fort;Collins Stock Plan #, List appropriate option #s a
UTILITIES INFO,.
Water Tap Size Sewer Tap Size. Metered: Yes
❑No�
Temp. Pedestal Yes[] No Ej
Gas ❑Electric Electric Main Breaker Sii.e (Residential only) 0150 Amp or Less 200 Amp Other
Type of Heat:El
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Value of Construction (including labor, material,& profit) 8 3 0 00 , 00 t
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Description of Work: a ` ✓ j e '
Contact Name & Phone # of JOBSITE SUPERVISOR
'Subcontractor lnfo s
Electrical Mechantcal J Plumbing
Framer �..�rAtr Roofing ~' Concrete` Fireplace id,
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Solar \ - Other V, Other Other
ant. I hereby dmowledge that 1 have read thus application�and state that the above information is correct and agree to comply with all req -Irl ments 1-)
. contained herein and City of Ilins o man staws te regulating titnlding constru on. •) ,Q, 4, 4 gp-pp !t
. Applicant Signature �2� Print NameC�i / / �� Phone / ^ ` -� '
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Distnbutron White -Office- Yellow-Applipnt :;;Pink-WVWVlStormwater 1 `
THIS APPLICATION EXPIRES 1180 DAYS FROM APPLICATION DATE