HomeMy WebLinkAbout1623 Laporte Ave - Applications/Shed - 04/23/2010City of
II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
�t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER R O C;I3 / / APPLICATION DATE / C�� —/-O
Job Site Address 167_3 AY, Pr c- Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 0 - 48 A - 6 2 3 e
Last name *4066 First Name Dl►N t 4' I_ Middle Q
Street Address 846 BALSAM /-Ak-f City G'TC State db Zip 8O526
CONTRACTOR INFO: Company Name N,
Lic Holder Name
Mailing Address
Contractor Phone
City of Fort Collins License # Supervisor Cert #_
LEGAL INFO:
Subdivision/PUD N A Filing #
�! A
CONSTRUCTION INFO: otal Building Sq Ft (not including basement)_
Residential Sq Ft Comm] Sq
161 Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
State
Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths /z 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. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
t,
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
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
00
Value of Construction (including labor, material & profit) $ 5
Description of Work: INbTJaIL PC, t~TAa, Z $To120,6E 15RIED tz-hA tLtT-t pN P-C>PEF---rti
Contact Name & Phone # of JOBSITE SUPERVISOR: nlwt%E l.-. R . gos5 470 ',484 — o 2 38
Subcontractor Info: IJlA
Electrical
Framer Roofing
Solar Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
M
Applicant: I hereby a nowle that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and of Fort Collinso
ordinances and stat laws regulating building construction.
Applicant Signature Ba". Print Name D Au1r-L Q , Yo$5 Phone 97o --484"o 7,38
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE