HomeMy WebLinkAbout2862 Kansas Dr - Applications/Deck - 10/28/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F&t'Collins
IT
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building !_
BUILDING PERMIT APPLICATION �i
APPLICATION NUMBER l� 1 APPLICATION DATE
Job Site Address 2—(la Z- V—AvVb 1 V fL `J ✓ UA�� T Unit #
-
PROPERTYOWNER INFO: (All owner information
Z information is required - it is not optional) Phone # �� 0 - 2- 1-1 " 414 y G
La&t-i to (Al a'Lr�S It 4,`�dl� - M First Name MA- VN%-, ��C -YWqjtj M14LMiddle
Street Address City State Zip
CONTRACTOR INFO: Company Name Co -�'0 A n� 2�- Contractor Phone # 3D3 - n) 611 —0(010
Lic Holder Name �• ,' 1�, `' C",�y� City of Fort Collins License # Supervisor Cert #
W
Mailing Address �IGLAO , CQi( ar- ®uo-Lyt- City �-KK\'vJOO ' State Zip 1507-2:?
LEGAL INFO: ((111
Subdivision/PUD CO -Al OAS -A,`t Z' j e^ r—onr v \S Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft
15' Floor Sq Ft
Finished Bsmt Sq Ft
Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft
3m Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/ 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) $ 1 C7, cgoo
Description of Work: 'Q,OAbU(, &U «P10\cR eAk j_1• A eeir,-,
Contact Name & Phone # of JOBSITE SUPERVISOR: I 1 sJ` yh C- 14 V Tr . -1 ZO " 3Z-0 •-'-i 7-0 0
Subcontractor Info: J
Electrical N 4' Mechanical N Plumbing 41A-
Framer �(Wc,�✓ t �l S jarhd Ai Roofing ly Concrete X n&rot 85 6,1 C.f Jt Fireplace
Solar (l-,f Other Other Other
Applicant: I hereby acknowl dgp 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 I�Collin rdina ces and state laws regulating building con//s��truction.,IApplicant SignaturePrint Name
i-F S )
l00 i(`� Phone "`f
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE