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HomeMy WebLinkAbout4918 HINSDALE DR - APPLICATIONS - 12/11/2009BUILDING PERMITS & INSPECPIONS DIVISION P.O. Box 580 a Fort Collins, CO 80522 LW • Phone: 221-6760 www fcgov conVbuilding City of Fort Collins BUILDING PERMIT APPLICATION APPLICATION NUMBER PA qC�� IAPPLICATION DATE Job Site Address `l_ / 19 111,141fa 4 iE Pa l Ve- Unit # , ^� q PROPERTY OWNER INFO: (All owner information is required -�i't is not optional) Phone #�/ ! 7 - 9 �/s - / / _77 Last Name VANAI / ©S, NfiC First N/�ametd, I�IC� a M-N� I Middle LE / J- p�� �'�/ Street Address-'/ 2�.� ��LL.F_ Of1A) ,DI K' City F6P-T 1f6L.UAIS State � 6 ZiP CONTRACTOR INFO: Company Name O W N Contractor Phone # Lic. Holder Name City of Fort Collins License # Supervisor Cert # Mailing Address CityState Zip LEGAL INFO: � �/ Subdivision/PUD 4!/- X EN6OId�1/ 9ILL-6 Filing # 3 44 Lot # BBII k # Lot Sqq Ft / CONSTRUCTION INFO: Tote Building Sq Ft (not including basement) o� u7 O 3f1iQ ) kK�ftlRftal Garage Sq Ft Gi g aNfk < Residential Sq Ft *693 4omm'lSqFt NOn1E # of Stories_ Bldg HeiahtQ �+ ^ • -��-�'Jnits 1 NHea+at 7Z/Jp 1st Floor Sq Ft J �)%11 ikM 2"a Floor Sq Ft r Unfinished Bsmt Sq F Fmi6hed Bsmt % Ft I # of Bedrooms _13 # of Full Baths 3 % Baths O % Baths I # of Fireplaces �/ WOOOS76 VE Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck n2ResCheck w/Air Sealing I 3. ResCheck wBlower Door 4. E-Slar wBlower Door 5_ Prescriptive w/Air Sealing 6. Prescriptive wBlower Door City of Fort Collins Stock Plan # List appropriate option #s UTILn1ES INFO: n l/'� i r Water Tap Size 3 Sewer Tap Size T Metered: Yes or No Temp. Pedestal: Yes or No Type of Heat )<Gas XElectric Electric Main Breaker Size (Residential only): 150Amp or/L�ess ❑ 20OAmp O Other ' Value of Construction (including labor, material & profit) $ 6t2fQ Description of Work: Contact Name & Phone # of JOBSITE SUPERVISOR: WA kk,GN VoDrA N 9 _i40- S- I 1 7T Subcontractor Info: Electrical _ Mechanical Plumbing Framer Roofing ng Concrete erI (� Applicant: 1 hereby acknowledge that I have read this application and state that the above information is correct and agree to comply all requirements contained herein and City oy Fort Collins ordies and state laws regulating building con 'or, , ��NN 70—>� r%S—( q -77 Applicant Signature�� �U^ Print Name Phone 5�,A-VLLe-M 410(,I-e— i on: White — Office Yellow — Applicant Pi — WWM8t rm water THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE