HomeMy WebLinkAbout612 Duke Ln - Applications/Addition or Alteration - 05/30/2019City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F61t+t Collins`281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER V I - I O 3 o-Z APPLICATION DATE S 60 I I
Job Site Address612 Duke Ln Go IUnit #
PROPERTY OWNER INFO: (All owner information Is required - It is not optional) Phone #
Last name KO,-j&"\/ First Name � � Middle a l
—Street Address--�I---1 —City Y �u44`I State zip So E —
CONTRACTOR INFO: Company Name Site Industries/ Basement Escape Contractor Phone #970-227-0789
Lic Holder Name Brian Stephenson City of Fort Collins License # 815 Supervisor Cent #
Mailing Address 519 N Overland Trail
citv FC
LEGAL INFO: yy
Subdivision/PUD C 5L,i '� Lo1�841� "05 Filing #,
State CO Zip80521
Lot # �— Block # 1 I Lot Sq Ft
—-CONSTRUCTION7NFO-Tot MU'ildirlg Sq Ft (not including basement)- t -�-otal-Garage Sq Ft - 2
-Residential-Sq-Ft Eomm'I Sq Ft # of Stories L--Bldg+leight i # Dwelling Units
J1'' Floor Sq Ft lam_ 20 Floor Sq Ft h/ct 3id Floor Sq Ft InUnfiished Bsmt Sq Ft
Fin ished-BsmYSq-F s--�tP1s�— 'J< Baths _fit ' isat f Fireplaces--�
Air Conditioning: Ye No® Energy info:( Circle appropriate choice) 1. ComCheck ❑ 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door I I4. Simulated Performance Alternative S. Prescriptive w/Air Sealing ❑ 6. Prescriptive w/ Blower Door
City of Fort Collins Stock -Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes ®NoTemp. Pedestal Yes❑ No ❑ _
Type -of -Heat: Gas Electric Electric Main Breaker Size (ResidentiaF only)-[] Amp or -Less 11 200 Amp DOther
Value of Construction (including labor, material & profit) $ %, o o o
-Description of Work:
Install 3 basement egress windows per IRC and attached engineering
Contact Name & Phone # of JOBSITE SUPERVISOR: �yi &-y\ 0
Subcontractor Info:
Electrical Mechanical
Framer Roofing
Solar Other
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 and City of Fo ollins Wi=cesstatews regulating building construction. V �p G
Applicant Signature Print Name PUni2.� t G3k4V Phone
Distribution: White -Office Yellow -Applicant Pink -WAW/Slormwater
THUS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
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