HomeMy WebLinkAbout4800 Langdale Ct - Applications/Addition or Alteration - 04/29/2014COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER b I402r)4A APPLICATION DATE 2D 19'
Job Site Address 4'j!iG0 L_c v-,Sckc,t_t:., L• -t Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name c �.r First Name '-X_C d C JnrA Middle
Street Address L-t(;2> c:(-;> c rt c, c c`lt_ CA City State &6 zip
CONTRACTOR INFO: Company Name 0 ILL 1p„Ln Contractor Phone # Q 7G -'Y1
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Lic Holder Name �L� t-c- h1 AI-e k c /1 City of Fort Collins License # -Sit Supervisor Cart #
Mailing Address 53 -? 2 E C_c R c-, :7 L( City ry State � zip 12)6-t,, 1- -
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft 200 Comm'I Sq Ft # of Stories Bldg Height
'Is' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
3rd Floor Sq Ft
# Dwelling Units
Unfiished 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. Simulated Performance Alternative 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) $ ? o , S_�=,
Description of Work: tr Gyr'lct�¢ l �citc ln1 vt IrC i/� 1() 1 _ (�✓�l� �c f�lrr�t,e� lip L-v)1xn v-, c
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Contact Name & Phone # of JOBSITE SUPERVISOR: '170 3cl 1
Subcontractor Info:
Electrical G c,2 i _S Mechanical Prt or Plumbing t' n
Frame6Lc-t To . ei Roofing Concrete Fireplace
Solar
Other
Other
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 ((tkao- 4 c'f) Phone Cl 7C_3'4"t 1 T�L( a(e
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE