HomeMy WebLinkAbout638 KIM DR - APPLICATIONS - 10/7/2008BUILDING PERMITS & INSPECTIONS DIVISION
PO Box 580 FortCollins CO 80522-0580 Phone 2216760
6iA www fcgov corn/buildingrty CofFortLa= BUILDING PERMIT APPLICATION
APPLICATION NUMBERlm) I Qv3s APPLICATION DATE I n I ul 12
Job Site Address - �36 k,A, or Unit #
PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone #
Last Name First Name IT�Ei� Middle
Street Address 6 8 y� k ,,.� t 1 r City Fo J Lo 1I, u S Statecv—ZipP,06-ill
CONTRACTOR INFO Company Name
Contractor Phone #
Lic Holder Name City of Fort Collins License #
Mailing Address_
LEGAL INFO
Subdivision/PUD
City,
Filing # Lot #
CONSTRUCTION INFO Total Building Sq Ft (not including basement)
Residential Sq Ft
1st Floor Sq Ft
# of Bedrooms
Air Conditioning Yes No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO
Comm I Sq Ft
2nd Floor Sq Ft
# of Stones Bldg Height
Supervisor Cert #
State Zip
Block # Lot Sq Ft
Total Garage Sq Ft
# Dwelling Units
Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft (D 30
# of Full Baths 3/4 Baths '/2 Baths
Energy info (Circle appropriate choice) 1 ComCheck
4 E Star w/Blower Door 5 Prescriptive w/Air Sealing
Water Tap Size Sewer Tap Size
List appropriate option #s.
# of Fireplaces
2 ResCheck w/Air Sealing
6 Prescriptive w/Blower Door
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
rrrv:� a 00
Value of Construction (including labor material & profit) $ (-I I VU I
Description of Work LJQ$Gy�T r l a slk
Contact Name & Phone # of JOBSITE SUPERVISOR
Subcontractor Info
Electrical
Mechanical
Plumbing
Framer Roofing Concrete 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 ordipancesland state laws regulating building construction G l
Applicant Signature 77—Print Name �t(l StC� ►AI Phone -17(/ ��q 030�
Distribution Whi ffice Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE