HomeMy WebLinkAbout505 Duke Ln - Applications/Addition or Alteration - 10/23/2013City
}of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 - Phone: 970-416-2740
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER S • 5OSS / I APPLICATION DATE 10 -o?3 - 1-�
Job Site Address �5_0.S _f��/Le % Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 9 % - 4ZO7- - $DD 6
Lastname �"i,f4titif�r First Name / Middle
Street Address • / City{ • '� //lnS State C aZip
CONTRACTOR INFO: Company Name NQ i w Gert.r, .,6',i $ar Contractor Phone # 97v - 9 h' 8'-63.?L
Lic Holder Name R 010 City of Fort Collins License # Supervisor Cert #
Mailing Address 9-7 It CAI 5c.4 tL -t>,f • City State Cn . Zip FSO,ZS
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) /Zoo Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
Is' Floor Sq Ft
2nd Floor Sq Ft
3n' Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft TOO # of Bedrooms 3 # of Full Baths Z 3/, Baths —'% Baths —# of Fireplaces
Air Conditioning. Yet]No® 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 Sealing11 S. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes ®NoE] Temp. Pedestal Yes❑ N0Lr%7fl
Type of Heat: 12Gas Electric Electric Main Breaker Size (Residential only) i 150 Amp or Less ❑ 200 Amp ❑Other
Value of Construction (including labor, material & profit) b� 000. 90
Description of Work: OPT tvt a IMP <T t-- ^A4 tn',o_k\S A-rd0't ( R-EF�_ PJ,60 10711ea M-_13K1-4Y .
Contact Name & Phone # of JOBSITE SUPERVISOR: _1� o� 'j j-el ,., IT?0-jR'&-L'?"?C,
Subcontractor Into: //��
Electrical Zu�✓iCori Mechanical )qalte'f Plumbing�taye !t%u�L6 t,
FramerA/ek tku,Al�1 Roofing Concrete Fireplace 67
Solar Other
Other
Other
Applicant: I hereby acknowledge that I have re this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins d state laws regulating building construction.
Applicant Signature Print Name iZo)D&Ler� Phone mil?O-'8d�'-46_U6
Distribution: White -Office Yellow -Applicant Pink -WWW/Stornwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE