HomeMy WebLinkAbout1023 Sabatino Ln - Applications/Single Family New - 07/30/2014City of I I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
((��, ( BUILDING PERMIT APPLICATION
APPLICATION NUMBER IPz40 lI 4c't _ APPLICATION DATE —3— 3O — I
Job Site Address LG ft-e_ Unit #,
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # / OZ5> —CJ l 0 Y]_L %
Last name ///Lat First Name �OGt 1^ Q L // Middle , `/OnC�
Street Address �'Zer 7 L Cikl jj.r / �JC�V % CitState L/ON/ zip
CONTRACTOR INFO: Company Name L� G�O�_��ttcc f / Contractor Phone # 7.V - 717 - �4 75 �
Lic Holder Name �1r0£S C-/`CZiC !Q/-�fp City of Fort Collins License # -�f �f % Supervisor Cert
Mailing Address .- 3ip,�i (�/�PP�L.CDuC� � 1 City Ce1� State 6ep zip A:ZD '
LEGAL INFO: /�j /�
Subdivision/PUD !(/eGL A (//_ Filing # Lot #�Block # Lot Sq Ft 337�
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) / 7A /O Total Garage Sq Ft 3 7�4
Residential Sq Ft Comm'I Sq Ft �7 # of Stories Bldg Height _ #Dwelling Units/
151 Floor Sq Ft 1 2ntl Floor Sq Ft 7 f7 3 T4 Floor Sq Ft Unfiished Bsmt Sq Ft
f177
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/. Baths Y: Baths # of Fireplaces
Air Conditioning: /Yest No Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Bloweerr Door &�imulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
t[' lI
Water Tap Size 3 T Sewer Tap Size Metere . Ye)or No Temp. Pedestal Yes or 60
Type of Heat: as ❑ Electric Electric Main Breaker Size �(Residential only) Z 0 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ �V lY �tJ410. OC.(- J�J ��J J /
Descciotion of Work: 4i1 Pt-_e Twice e,76 z.n /%i C_ �i/2t CP_ �Gr r*V �j Oi ff4 C &o / �'l�e_
Contact Name & Phone # of JOBSITE SUPERVISOR: - i� / O -,'//s?= %
Subcontractor Info: /- n
Electrical /'i LLv�G Mechanical /'n f 4114) Plumbing
Framer /t Roofing Concrete _N .+/4 a 1, /��1 Fireplace
Solar
Other
Other
Other
Applicant: I hereby acknowled a 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 o Collins ord' ces d state laws regulating building construction. �/f/% �- - '9;! �/
Applicant Signature Print Name �/a6t/l / r//YlG Grlf' Phone O ��'A6"
Distribution: White -Office Yellow -Applicant Pink - WWW/Stonnwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE