HomeMy WebLinkAbout3844 Cosmos Ln - Applications/Single Family New - 11/16/2010Fort Collins
APPLICATION
Job Site Address
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION DATE // ✓14 ✓1
Unit #
PROPERTY OWNER IN O: (All owne 'nfor a jo ''required - it is not optional) Phone # j - /� J
Last n" • " 4 ��`F'i s tear �'j Middle
Street Address O 4!E Q/' %Gt! At9lA 7-/600 City � � wl�� - State_0Zip Q ll
CONTRACTOR INFO:
;Company�N%ame Contractor Phone #
Lic Holder Name /LD/w l Vrj/ri City of Fort Collins License #1)-Iol� Supervisor Cert# Q 'lam
Mailing Address City State Zip
LEGAL INFO:y -
Subdivision/PUD� ,O/ U,—bt4 �/% l� Filing # —" Lot # � � Block # Lot Sq lFt L£ OC3Q
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 215'7 Total Garage Sq Ft 3
Residential Sq Ft -6-7 Comm'I Sq Ft �-"# of Stories 2- Bldg Height 2 , I u # Dwelling Units
1 s' Floor Sq Ft 10 I 2-1Floor Sq Ft 11440 3rd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft —lam # of Bedrooms 3 # of Full Baths -2—'/4 Baths '/2 Baths I # of Fireplaces
Air Conditioning: YesWJon Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door ❑4. Simulated Performance AlternativeR15- Prescriptive w/Air�Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # t-T IV List appropriate option #s it IT
UTILITIES INFO:
Water Tap Size a Sewer Tap Size Metered: Yes ENoF] Temp. Pedestal Yes[RNo
Type of Heat: RGas ❑Electric Electric Main Breaker Size (Residential only) R150 Amp or Less 11 200 Amp DOther
Value of Construction (including labor, material & profit) $ Z-0 0!;)1L
Description of Work:
V.
Contact Name & Phone # of JOBSITE SUPERVISOR: Z�jzw A180117 30.3 -
Subcontractor Info:
Electrical Mechanical _ Plumbing � 6 A yal;lli
��l oncrete /
rV L��Q%h (/�placeFrameo/k�L f
Solar
Other
Other
Other
Applicant: I hereby acknowledge that I �v read th s plication and state that the above information is correct and agree to comply with all requirements
contained herein and City of F rt Co inan nd ate laws regulating building construction.
Applicant Signature Print Name /// ��%%S7`TDI%iI Phon /u - 7�3 � 73�
Distribution: White - Office Yellow - Applicant Pink - W1NW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE