HomeMy WebLinkAbout749 Sandpiper Pt - Applications/Addition or Alteration - 01/04/2018City of 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 APPLICATION DATE 1 _ L4 , f
Job Site Address 7119 ,Saa dn; /Icy/- Aji Unit #
PROPERTY
IIa /
OWNER INFO: (All owner information is required - it is not optional) Phone # / 70 -J i 0 " %O 0
Last name La V c { doll / K o tJ' 4 /First Name Andres -S ee/n Middle COStreet Address 7 y I H IOAr// r //,'' f' City jF CO l ) ✓IS State � t� Zip �5:1 $—
CONTRACTOR INFO: Company Name JL4 Li-Ke 14eme 6 I oki Contractor Phone # g 769 - 7Cf0 - / 3 a
Lic Holder Name r ' to f ,11CA / City of Fort Collins License # 3 79 6 -Qa. Supervisor Cert # - I S
Mailing Address Y n City P1 G ///4 S State r D Zip S 05 0'� I
LEGAL INFO:
Subdivision/PUD Filing # ^r� Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 11 p Q / t7 (J Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
151 Floor Sq Ft
Finished Bsmt Sq Ft
2"d Floor Sq Ft
3r1 Floor Sq Ft
# of Bedrooms # of Full Baths '/< Baths
Unfiishhed Bsmt Sq Ft—
/z Baths Y # 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) $ 3 01 D (9 fl /1 'YA 164 10411 Z4! -.
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Contact Name & Phone # of JOBSITE SUPERVISOR: Mark ►a r V i c r 7 P - q r/ l 3 `�
/, D r''1
Subcontractor
Info: / f - f I
Electrical b(Up, ,'h e, C'ei�T* 1 G Mechanical t Plumbing �+h ' a ry 14) It
Plum
Re
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 or a to laws regulating building construction. , /
Applicant Signature Print Name j� a P � Vjlci/ reo Phone 9 749 rFOV - 13.28
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE