HomeMy WebLinkAbout648 LESSER DR - APPLICATIONS - 1/13/2012City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ `� www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER VVI- b b t b 3 APPLICATION DATE I— l':�— I
Job Site Address �48 Lrr-SS4(L ts2 Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name H ao� ass &-) First Name K O LL i Y Middle
Street Address LLI 'F3 Le ssq , N2 City i (OC.4-t ADS StateC-0—Zip "-
CONTRACTOR INFO: Company Name l r pvWSQ. Contractor Phone # 970 - lff& - (000a
Lic Holder Name c�l vta City of Fort Collins License #-9- 90. Supervisor Cent #
Mailing Address - ,955 G , 6k. C City /x )LU� State On Zipjg2as 7
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) l S F Total Garage Sq Ft AJA
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
2nd Floor Sq Ft
3r1 Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft A YA # of Bedrooms a # of Full Baths —I— % Baths - 4, Aq '/2 Baths % # of Fireplaces f
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:
List appropriate option
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) $ �� ; _I "1 o , 98
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical KIS LL$C-talc Mechanical;
Framer
Solar
Plumbing 6coRADC) I LUth&IA DC
Other Other Other
Applicant: I hereby acknowledge jtat I I ve application and state that the above information is correct and agree to comply with all requirements
contained herein and City o ollin (d' and state laws regulating building construction.
Applicant Signature Print Name AC K A2W Kot 64C k PhoneC?10, 3 1R 191(+
Distribution: hite-Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE