HomeMy WebLinkAbout508 HUNTINGTON HILLS DR - APPLICATIONS - 5/17/2011BUILDING PERMITS & INSPECTIONS DIVISION
cii6:ii'A P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
CRyofFort Collins BUILDING PERMIT APPLICATION
APPLICATION NUM i nr, APPLICATION DATE
Job Site Adlciress 5 S Uv► ���, l�s fir•�i✓ CU525'U1-i4 �1
PROPERTY OWNER INFO: (All owner information is required — itis,�not optional) Phone # ! 7D - ZO�I " O LIR
Last NameIlt' _as) Qi� First Name '`i cApi,,f— 1 j Middle J,
Street Address_ 5DRZ to a AC4-�),j Lb l IS D r CityE� co State LO Zip 65 Z
CONTRACTOR INFO: Company Name (,ki 0 P, Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
Subdivision/PUD 4,Aych,/,A—�0VI fT, Os Filing #K_ Lot # 15 _ 1 Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 2 6 5 Total Garage Sq Ft 650
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft
# of Bedrooms
Air Conditioning. � No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# of Full Baths % Baths '/ Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option
6. Prescriptive w/Blower Door
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) $ , 1, C) Uo
Contact Name & Phone # of JOBSITE SUPERVISOR: _AA L, h ac, 1 (_ess le r, cc I (2" 1 Z7 z-
Subcontractor Info:
Electrical Mechanical N/TI Plumbing N/A
Framer ` 14 Roofing AL Concrete Other
Applicant: I hereby acknowledge that I have read this application and state that. the above information is correct and aaree to comply_ with all reouireme
contained herein and City of fort Collin rdinances and state laws regulating building construction.
Applicant Signature Print Name M i,V�tk C. ( f 55�P.� Phone q 1 Z -/ 27 Z
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE