HomeMy WebLinkAbout2113 Kirkwood Ct - Applications/Addition or Alteration - 05/15/2017City of
I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
'■s111111 R%IUO_ nCQulT Anal ld%AT1AY
Job Site Address
PROPERTY OWNER INFO (All owner information is required — it is not optional) Phone #
Last name Se, erlI,, First Name Middle 2
Street Address L N11�Z .IrkW0tA CA- City r'ruli"S State -do —Zlp-92aT�
CONTRACTOR INFO Company Name
Lic Holder Name
Mailing
Contractor Phone #
City of Fort Collins License # SupervisorCart #
State Zip
LEGAL INFO ,j ca y (S goY2x -t2C h. Ccs^vv�
Subdivision/PUD %Ili 1 /fA Filing # Lot #oP JBlock #
Lot Sq Ft o. for
CONSTRUCTION INFO Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft
15i Floor Sq Ft
Comm'I Sq
2"d Floor Sq Ft
# of Stones Bldg Height # Dwelling Units
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished 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
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
ao
,Value of Construction (including labor, material & profit) s O�
— — V' �. F t lJ� - 1- 1 1
jDescription of Work l V
Contact Name & Phone # of JOBSITE SU
Subcontractor Info
Electrical 117 Mechanical
Framer
Solar
Roofing
Other
Concrete
Other
Plumbing
Fireplace
Other
Applicant I hereby ackno edg that I h ve read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City f Fo Collins rdinances and state laws regulating building construction
Applicant Signature Print Name l) 1 �Pti'one
Distribution White — Office Yellow — Applicant Pink — WWW/Stormwater =—n
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE