HomeMy WebLinkAbout616 Tulane Dr - Applications/Addition or Alteration - 04/19/2017City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave • Fort Collins, CO 80524 a Phone: 970-416-2740
/ wwwfegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 6 M o a -Ds 3 APPLICATION DATE I 1`- I I
Job Site Address
TVt�A`0
D F09_fC-6"4"5 Ca Unit #
go 52S
PROPERTY OWNER INFO.
(All owner Information is
required - It is not optional) P/h'on-e,,#
Last name Isbo C'U h"
First Name T)�r D 1`- `� `� Middle
Street Address 6 r 6
TU&1'r-fO
City 6 %Z r C6 (/ [�(A6
SSttate L D zip ga 2 S
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CONTRACTOR INFO Company Name `i1170
5E14V1«S L �„tractor Phone# 'SO
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Lic Holder Name A'A(M
I %ZA I ^i0 r2-
City of Fort Collins License # D-7 8 8
Supervisor Cert# 3$140-9 (
Mailing Address 102 56lr7-H 5r Go f 5 *v€ ON State 60 Zip `56S17
Subdivision/PUD ! f 74-7 - 600 t-H (0'(,t06 Filing # Lot #_I_ Block # - Lot Sq Ft
H6fb*fTs
CONSTRUCTION INFO. Total Building Sq Ft (not Including basement) ft �'� Total Garage Sq Ft
Residential Sq Ft () Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1 °' Floor Sq Ft 1 2u0 2nd Floor Sq Ft i 31' Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft 1 -ZD # of Bedrooms # of Full Baths 3/, Baths Yz Baths # of Fireplaces
Air Conditioning Ye&o Energy info ( Circle appropnate choice ) 1 ComCheck 2 ResCheck w/Air Sealing 11
3 ResCheck w/Blower Door11 4 Simulated Performance Alternative❑ 5 Prescriptive w/Air Sealing 6 Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO,
Water Tap Size Sewer Tap Size Metered Yes ❑Nol:l Temp Pedestal Yes❑ No ❑
Type of Heat n Gas ❑Electric Electric Main Breaker Size (Residential
only) �150 Amp or Less ❑ 200 Amp Other
Value of Construction (including labor, material & profit) $ 5 C) y
Description of Work
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Contact Name & Phone # of JOBSITE SUPERVISOR A
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Electrical iT UJf 1 F LEG Mechanical A&V5 A(,( r114'A If' Plumbing Al ov F_ At-L, P/�wr�flVGl
NE�r ,hrl2
Framer 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 reg lating building construction
Applicant Signature Print Name—FINI &HAli57X6M Phone 27o "W -26-3
Distribution e - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE