HomeMy WebLinkAbout912 CHEYENNE DR - APPLICATIONS - 5/20/2005 (2)a
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 - Fort Collins, CO 80522-0580 - Phone: 221-6760
www.fcgovxom/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 8 OS na��Zl % APPLICATION DATE '5—'' 490 —6�5-
Job Site Address I dt c keyen ne- Dr , Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 17y — a as - O a.11
Last Name ��+ ✓a First Name Q0h Middle LyG l��r
Street Address City F+ ✓ X State CO zip $ 03
CONTRACTOR INFO: Company Name
Contractor Phone #
Lic. Holder Name City of Fort Collins License #
Mailing Address.
LEGAL INFO:
City
Supervisor Cert #.
State zip.
/ f-h p.
Subdivision/PUD �r� �►rAr. a, f 1S �%_ Filing # � Lot # Block # Lot Sq Ft 12. 1 ct
CONSTRUCTION INFO: Total BuildingS Ft not including basement S-. D Total Garage S Ft
q ( s ) - 9 q `li
Residential Sq FtQ(A 17 Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft J.S O 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft O v
# of Bedrooms # of Full Baths 1 % Baths '/z Baths # of Fireplaces
Air Conditioning: No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6 Prescriptive w/Blower Door
_ List appropriate option #s
UTILITIES INFO:
10 Ir
Water Tap Size 'S/41 Sewer Tap Size 9 Metered G>r No Temp. Pedestal: Yes ore \'
Type of Heat: AGas ❑ Electric Electric Main Breaker Size (Residential only): X 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ gn0, 000
-- -^ -
Description of Work: I Re_ "n o V e 1M R 1 I S y,� t� aK ! / /3 i P C P yy
or
mm
Contact Flame & Ph ne of I SITE SUPERVISOR:
S o J O 00., A ��-022
Subcontractor Info: n - !�'�JD�a.�,✓ � S �� �4,"`",5
Electrical C VL ate ice• L C k Mechanical /V Plumbing
Framer R£�5 1 �T t0.� � ��toofingIV4 Concrete / r' 14 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 Collins ordi ces and state laws regulating building construction.
%�
Applicant Signature Print Name UOh G V &ny7 Phone � 0 D
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE