HomeMy WebLinkAbout3738 Cosmos Ln - Applications/Single Family New - 05/21/2010City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Coll nS 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER B /V 0 J `/ 1 // APPLICATION DATE -In
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Job Site Address�E (,o: ✓% 4 S L_ei nP Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 3n3- -7� �- 92 3 `l
Last namel/First Name Middle
Street Address U ��� F QrCh� rd City&Z/'%1/,k y/4jjT State C_.LJ Zip2!&L
CONTRACTOR INFO: Company NameContractor Phone
Lic Holder Name M!Q, a/f i�/� City of Fort Collins License #D-Q7 Supervisor Cert# 9 G-
Mailing
City.
State
LEGAL INFO:
Subdivision/PUD( Filing # /, //77
Building Sq Ft (not including basement) /Y)& L Total Garage Sq Ft
CONSTRUCTION INFO: Total
Lot # zr � Block # Lot Sq Ft � _
Residential Sq Ft 7 Comm'I Sq Ft — # of Stories z
1 °' Floor Sq Ft / -7 7 2n° Floor Sq Ft _Oql 31 Floor Sq Ft
Bldg Height Z7 / %C) t1 #Dwelling Units A
Unfiished Bsmt Sq Ft -<2,�—
Finished
Bsmt Sq Ft C% # of Bedrooms � # of Full Baths Baths '/� Baths � # of Fireplaces
S I'
Air Conditioning: YetNoLl Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air ea ing
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO: , /
Water Tap Size 3 7 r/ Sewer Tap Size 'r Metered: Yes [DNo[:] Temp. Pedestal YesD No
El
Type of Heat: [jGas Electric Electric Main Breaker Size (Residential only) [150 Amp or Less ❑ 200 Amp DOther
Value of Construction (including labor, material & profit) $ / / I / D� Z ' Zy
Description of Work: �(il /10
0(,
- In
Contact Name &Phone # of JOBSITE SUPERVISOR: Ir1/1 d&V/4 3:;�-3 - 01- �iD/Zi
Subcontractor Info: / / / �{ �7 /
Electrical Mechanical�P% i] 17�1 et-7'r/%Plumbing Z1411, %I/TF��
Tom/ C
Framer Roofing �� Concrete / nOif// 0eFireplace A%ylL , /C t ,�iC.e,
Solar
Other
Other
Other
Applicant:
I hereby acknowledge at I have r this application and state that the above information is correct and agree to comply with all requirements
contained herein and City, of Fo ins or, ' n sand state laws regulating building con tructttion.
Applicant Signature Z Print Name ,1 I / /712S Ti' Phone
Distribution:
White -Office Yellow -Applicant Pink- W1MN/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE