HomeMy WebLinkAbout619 AGAPE WAY - APPLICATIONS - 3/16/2010City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins 281 N College Ave Fort Collins, CO 80522 0580 Phone 970 221 6760
/ www fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER- BIM /32-T APPLICATION DATE 1VM 24ol6
Job Site Address do/4 A -(;A& UTA-Y SoSzq Unit #
PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone # 2 -L Jam -
Last name kN &66,9 First Name 13rLUC F- Middle
Street Address 61 I 4-6A-pr UlAy City rY �/41�1N-S State6:) Zip
CONTRACTOR INFO Company Name
Lic Holder Name
Mailing
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
State Zip
LEGALINFO n
Subdivision/PUD SANO G /c�e�t Filing # Lot # 3 Block # Lot Sq Ft 76 S 6
CONSTRUCTION INFO Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft
1 i Floor Sq Ft
Finished Bsmt Sq Ft
Comm I Sq
2 d Floor Sq Ft
Bldg Height # Dwelling Units
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/, Baths '/2 Baths # of Fireplaces
# of Stories
31 Floor Sq Ft
Air Conditioning es No Energy info ( Circle appropriate choice ) 1 ComCheck 2 ResCheck w/Air Sealing
3 ResCheck w/Blower Door 4 Simulated Performance Alternative 5 Prescriptive w/Air Sealing
City of Fort Collins Stock Plan #
UTILITIES INFO
List appropriate option
6 Prescriptive w/ Blower Door�1
60�
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) $ 3 ! % % ,,
Description of Work LIGHY U1ejjCe(' TRA�t/S�U� o-a� /JfA1rL l.1-P G -r /-70
Contact Name & Phone # of JOBSITE SUPERVISOR ;69U GC 4'N464 6f Z 51S 4'/6 h6i1 Z797 5-
Subcontractor Info
Electrical
Framer
Solar
Roofing
Other
Mechanical
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 F Collins rdin Ces and state laws regulating building construction y
Applicant Signature PnntName�ieUG� /C/iJ/��4� Phone Z9SL//6n
car i i 17 tee ho
Distrib on White -Office Yellow -Applicant Pink- Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE