HomeMy WebLinkAbout2352 Kansas Dr - Applications/Temporary Structure - 09/20/2005y`.
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City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 - Fort Collins, CO 80522-0580 - Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1AI Vl ! APPLICATION DATE - w
Job Site Address _ 2 3 S'Z K4 , co j, Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone W iS 33
Last Name a /, First Name_ Neal Middle
Street Address_ :7 35 L/ City�,Q�.�ti �(Q State_zip 90007
CONTRACTOR INFO: Company Name �h , c (Q/t ail.[ lra� Contractor Phone
Lic. Holder Name M444 ,J -4 h, ;, r City of Fort Collins License # Supervisor Cert #
Mailing Address_ 07-f- r� City_ gf,gl AO,, State L.LU zip F0603
LEGAL INFO: t
Subdivision/PUD a/ - �e/or.��, 4 Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO• Total Building Sq Ft (not including basement)
5 ;? re Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
1st Floor Sq Ft
2nd Floor Sq Ft
# of Stories_ Bldg Height j Z / # Dwelling Units
Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option #s
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) $
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical l�dy ri u0c� 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 construction.
Applicant Signature Print Name_ J r Phone 30 ).- `?W-22�
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Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE