HomeMy WebLinkAbout602 KEENESBURG CT - APPLICATIONS - 8/15/2005BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcsov com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER Vv v V `' APPLICATION DATE
Job Site Address iPO,2- f<eehes burg C-a,. -t Unit #
PROPERTY OWNER INFO:
(All owner information is required - it is not optional) Phone # lob - 2? % 7
Last Name 141 { kwiceFirst Name iz O of Middle
Street Address �0��
��iI'F1�1ar� L°'�.
F�. ���%nS
State Ccp Zip gOT-2.S
CONTRACTOR INFO:: Company Name KC S &—e f
n /City
k • /c[C y S Contractor Phone #
'i .2y- SO S %
Lic. Holder Name 00"
Sccr&�-A
City of Fort Collins License # l7.2 -%o
Supervisor Cert # 206l0
Mailing Address 30 % /'✓%o/I
t�2 ACn /e L >� •
City_rL - Co%%� .1S State
CO Zip Re> g-.Z G
LEGAL INFO:
Subdivision/PUD
Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft 5?-5-0
# of Full Baths % Baths I '/z Baths
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option #s,
# of Fireplaces
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
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) $_ ;LO 0C�'
Description of Work: (5 4 sere -, 4 P ^ ; S k
Contact Name & Phone # of JOBSITE SUPERVISOR: Do, S'eof"t ygf - (ol Y
Subcontractor Info:
Electrical `Qr%r`st- 71ee-Lr: e
Framer
Mechanical 0p�� Plumbing I' 1 4
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 Ci of Fort Collin rdinances and state laws regulating building construction.
Applicant Signature Print Name DOS SC,V'&- Phone 22-Y-SO%
Roofing
Concrete
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE