HomeMy WebLinkAbout6315 WESTCHASE RD - APPLICATIONS - 2/11/2011City of
Frt Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N College Ave Fort Collins CO 80522 0580 Phone 970 221 6760
www fcgov com/budding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER % 1100 { APPLICATION DATE 0 I I I ZD I I
Job Site Address ((3 j�j (,J Qhi(�, , c f c� Unit #
PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone #
Last namef\C lyel� r \ - I First Name �Gc u Middle n
Street Address W 016t � ,e, (—J— City �- rL State C Zip 3,5 ZLS
CONTRACTOR INFO Company Name Oe. 4,ic- 0k)4+Q M, NiArS Contractor Phone # 9-4 3-77-239k)
Lic Holder Name City of Fort Collins License # a ZDZ Supervisor Cert # J
Mailing Address t-i urr CitState CO Zip 9Q5Z %
LEGAL INFO
Subdivision/PUD 1 {4-C. Fdmg # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO Total Building Sq Ft ( t I d g b m
Residential Sq Ft Comm I Sq
1 Floor Sq Ft
2nd Floor Sq Ft
Total Garage Sq Ft
# of Stones Bldg Height # Dwelling Units
311 Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft i51(g # of Bedrooms A- # of Full Baths / Baths __t__ / Baths — # of Fireplaces
Air Conditioning Yes 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 6 Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO
Water Tap Size Sewer Tap Size
List appropriate option
Metered Yes or No Temp Pedestal Yes or No
Type of Heat 5<Gas ❑ Electric Electric Main Breaker Size (Residential only) 150 Amp or Less .�200 Amp El Other
Value of Construction ( ncluding labo material & profit) $ 1r1 �vl "i ✓�
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR
2
Subcontractor Info
Electrical kc Mechanical PVA Plumbing (1618( c) �lV►ti�lh.
Framer oUdwbtzk Cf) Roofing Concrete / Fireplace
Solar Other Other 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 ord na es a d state laws regulating building construction ,(%
Applicant Signatur Print Name �(,Q (ILt Phone r,5(, 7
v
Distribution White - Office Yellow - Applicant Pink - WWW/Stonnwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE