HomeMy WebLinkAbout820 Benson Ln - Applications/Addition or Alteration - 11/30/2009��-� BUILDING PERMITS & INSPECTIONS DIVISION
PO Box 580 Fort Collins CO 80522-0580 Phone 2216760
www fcgov coin/building
6City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 17 ( / V / 6 IT APPLICATION DATE
/
/ 3v
Job Site Address99V -S&A 41 F--od--k C o/ / gr,o-1OSUnit
# ,,//
PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone # 9 70 - V,;-, o - yS-3 Z
Last Name b U W First Name c_ h rr S �J) Ik ea / j Middle
Street Address g 1-03 e#\-3 0-1 Z01 City rG�t ca G/t N S State C _Zip ffd .So2S—
CONTRACTOR INFO Company Name CO C33 Contractor Phone # 303 - y3'( ` 790 Z
Lic Holder Name
Mailing Address_
LEGAL INFO
Subdivision/PUD
City of Fort Collins License #
City
Filing # Lot #
CONSTRUCTION INFO Total Building Sq Ft (not including basement)
Residential Sq Ft
1st Floor Sq Ft
# of Bedrooms
Air Conditioning Yes No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO
Comm I Sq Ft,
2nd Floor Sq Ft
# of Full Baths
Supervisor Cert #.
State Zip
Block # Lot Sq Ft
Total Garage Sq Ft
# of Stones Bldg Height # Dwelling Units
_ Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
_ % Baths '/2 Baths # of Fireplaces
Energy info (Circle appropriate choice) 1 ComCheck
4 E Star w/Blower Door 5 Prescriptive w/Air Sealing
A n�
JY 1
List appropriate option #s
2 ResCheck w/Air Sealing
6 Prescriptive w/Blower Door
Water Tap Size Sewer Tap Size Metered Yes or No Temp Pedestal Yes or No
Type of Heat ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor material & profit) $ so gloc-i 00
Description of Work 06/Ko" e V' �e)0 1 o.e-P St t C tic, 3(3 SF, C tea V• 5 c)c 25 SF , P".4 %`9`"�/
ePAl@c-e daPw Ler ecr- 313 S F . 4eo owe t(-Aelta,-G G ?e&aa e & .e. -9;t
Contact Name &Phone # of JOBSITE SUPERVISOR 00na--1 ��,�'SO,
Subcontractor Info
Electrical
Mechanical
Plumbing
Framer Roofing Concrete 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 constructions /�
Applicant Signature 0"j) ee �.0-��— Print Name aQfIr-(VC (a�4 Phone 503
Distribution White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE