HomeMy WebLinkAbout6227 WESTCHASE RD - APPLICATIONS - 9/20/2010City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F®rt Collm 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416=274C
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER '� K�/L�� APPLICATION DATE 2D
Job Site Address Wall Unit #.
PROPERTY OWNER INFO: (All owner .information.1s.required - it.is.not optional) Phone.# X.L -451-1
Last name 1-10./�n1nrQ� First Name Lewi 5 Middle
Street Address (22_7 U 051 -a.i�ti e, 7--cud City R.CJ6,15 State zip'5052
CONTRACTOR INFO: Company Name I OA(nv►r►n ��S Contractor Phone #,270 - ic, 3o
Lic Holder Name I-4arYm //Fenn ael n11 City of Fort Collinsi1License #G _ 13 ( Supervisor Cert #
Mailing Address 57� W b�� �i-cP2+' City I=QLN �10" State 60 zip&536
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
-Residential Sq Ft Comml Sq Ft # of Stories Bldg Height # Dwelling Units
15i Floor Sq Ft
2nd Floor Sq Ft
3nd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths M. Baths # of Fireplaces
Air Conditioning: YeGon Energy info:( Circle appropriate choice) 1. ComCheck [l 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door' F14. 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 Sewer Tap•Size Metered: Yes E]NoE:ITemp. Pedestal Yeses -No F]
Type of Heat: F1 Gas ❑Electric Electric Main Breaker Size (Residential only) 1-1150 Amp or Less 11 200 Amp DOther
o.o
Value of Construction (including labor, material & profit) $'21105, r
Description of Work: Sr%4^11 A-Wo n eW W ;-jo W S in t rwi; n lie l 1 i V ins r6 o rn • Gctc.% P;,Al ota ry►QASrnrff,
—1 . 1 - _ i' I if 1 ..... i - , _r 11 a .% %. ..-1. 1 - -- ----- - I t -
l
Contact Name & Phone # of JOBSITE SUPERVISOR: �hac-N+ Ar-h-6to-r -00-?(o
Subcontractor Info:
�— Mechanical
Electrical
Framer MA n Roofing
Solar
Concrete Fireplace
Other Other
e-- 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 Fort Collins ordinances and state laws regulating building construction. Applicant Signatures Print Name /"VKJG Phone a /^7
a - 830
Plumbing
Distribution: White - Office Yellow- Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE