HomeMy WebLinkAbout1321 Leahy Dr - Applications/Single Family New - 12/28/2016City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
2 BUILDING PERMIT APPLICATION
APPLICATION NUMBER aALI O-I I1.t on
\ -Y • APPLICATION DATE � • Z 8 Zdl (e.
Job Site Address
Unit #
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PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # T�n- (do-f -)
Last name I I 4c i ^ LPN INQ j First Name Middle
Street Address tti City Ln elaviq-Sttatec�Zip%
CONTRACTOR INFO: Company Name V15WAyl Ila NOy�eS. Lid. Contractor Phone # I fo-�D��-la9oa
Lic Holder Name E(-e c�0 l4/,� City of Fort Collins License # Supervisor Cert #
MailingAddress�t , 5t" �f- citdouelaAAJState CO zip So637
LEGAL INFO: n 7 -71 A
Subdivision/PUD 11(� f� Si Ir b�>P Filing #__ Lot # Block # —' Lot Sq-L� F/
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) ,DI Total Garage Sq Ft n
Residential Sq Ft� Comm'I Sq Ft # of Stories Bldg Height as p� # Dwelling Units
1s' Floor Sq Ft Q , I� 2ntl Floor Sq Ft 31 Floor Sq Ft Unfiished Bsmt Sq Ft any
Finished Bsmt Sq Ft # of Bedrooms � # of Full Baths � '/a Baths '/z Baths # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. R ec Blower Door 4. Simulated
GPerformance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # 2 -3 J List appropriate option #s
UTILITIES INFO:
N tl
Water Tap Size 3�y Sewer Tap Size l Metered Yes or No Temp. Pedesta Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) X150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ Don, M
Contact Name & Phone # of JOBSITE SUPERVISOR: Fre Ceske (9-0) 319- -f 19 W
Subcontractor Info:
Electrical J1W►r'ICO. A 9I A 6C Mechanical IFiOUlf JeC{, y)5 V I ( PlumbingTic PILLVIbIVIC4
Framer ►A� 11 1� �V oofing k l C oncrete l P 1 Fireplace
Solar ICI V 1 Other Other Other
Applicant: I hereby acknowledge that I have re d this application and state that the above information is correct and agree to comply with all requirements
contained herein and Ci of Co iqs on i n sand state laws regulating building construction. //''�� I/� JJ�� %/_
Applicant Signature ) Print Name rf ed I.wL= Phone 7o- Y711(�
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE