HomeMy WebLinkAbout4501 S LEMAY AVE - APPLICATIONS - 5/26/2011City of
art Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740,$1 ?N 1Q
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www.fegov.com/bulicring
BUILDING PERMIT APPLICATION
APPLICATION NUMBER - 0a6p APPLICATION DATE
Job Site Address 4501 South Lemay Avenue_ Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
70 SZ 6 Z$vl
Last name -First Nam Tee6�l"' Middle 0 Street Address _ Zip
-
4501 South Lemay Avenue Fort Collins CO 80525
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City State
CONTRACTOR INFO: Company Name _ Contractor Phone
Lit Holder Name, - City of Fort Collins License # Supervisor Cert #
Mailing Address __ ____ __ City _. State zip
LEGAL INFO:
Subdivision/PUDSPint Of JOY __ _, Filing #. Lot # �! Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 1 �� r 7� Total Garage Sq Ft
Residential Sol Ft - _ _ ,Comm'I Sq Ft _ # of Stories 1 Bldg Height 31 9 # Dwelling Units
111 Floor Sq Ft 2n° Floor Sq Ft. 3id Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsrnt Sq Ft # of Bedrooms # of Full Baths % Baths Baths # of Fireplaces
Air Conditioning: Yes✓ Nog Energy info:( Circle appropriate choice) 1. ComCheck z 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative❑ 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # - _ List appropriate option #s
UTILITIES INFO:
Water Tap Size Existing; . Sewer Tap Size Existing Metered: Yes [:]NoE] Temp. Pedestal Yesa No ❑
Type of Heat: a Gas ❑Electric Electric Main Breaker Size (Residential only) Ell 50 Amp or Less 200 Amp 00ther
Value of Construction (including labor, material & profit) $ $1,000,000
Description of Work: _
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info
Electrical Mechanical _ _ Plumbing
Framer _ Roofing Concrete Fireplace _
Solar _ ____ _ Other -_- Other Other _
Applicant: 1 hereby acknowle that I have read this ap ication and state that the above information is correct and agree to comply with all requirements
contained herein and City o Collins ordinances a te,laws regulating building construction.
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Annlirant Signature alt;k Print Name_ Z a. t'cl - D- �W(G Phone 9 7a .SZ1+ 280(
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Distribution: White - Office Yellow -Applicant Pink _ vVM/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE. �o�