HomeMy WebLinkAbout1940 Larkspur Dr - Applications/Addition or Alteration - 07/25/2018City of COMMUNITY DEVELOPMENT & NEIGHBORHOO 1 SERVICES
FOI t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 2 ``f) D u o s APPLICATION DATE I 0-�Z I I lJ
Job Site Address L Ksmi 12 Unit #.
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name t . '� First NameMiddle -�
Street Address City —'/ State�w;�Zip
CONTRACTOR INFO: Company Name 'Contractor Phone # Q 71 } --:7 W I-� 2I� --/S 1.,
Lic Holder Name Z City of Fort Collins License # b Supervisor Cert# %//J / -/ -cl
MailingAddress�Q�Ljkj / j%� [2 City State_Zip Ti
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Filing # Lot #.
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft # of Stories Bldg Height # Dwelling Units
1 s' Floor Sq Ft
2ntl Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/4 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)
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical A Mechanical
Framer
Solar
Roofing
Other
j . I
Concrete
Other
Plumbing
Fireplace
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 andCityof Fort so nces and state laws regulating building construction.
Applicant Signature_ A C —0 Print Name b z dA i 1mr, Phone %-A/Q-0376]
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE