HomeMy WebLinkAbout626 LANGDALE DR - APPLICATIONS - 8/12/20141
08/07/2014 14:53 9705930124 GOLD ROOFING INC PAGE 01/01
FoCollinsCOMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
ft�.V M W "llsoo Avw • Part Collins, CO $05Z4 • Phone: 9ft41&W W
www f soucossnbttihline S I b2.4D
BUILDING PERMIT APPLICATION
MIRU CATIM NUtritaE��� v v AIMUCATION PATE
Job Site Addt►et>le �T n fe. Unit #
PROPERTY rIM-Eft INFOw (AR owner InIbnastion is required - Itis,not optional) Phone # �l �Ci � 2 ZGj ^ 4241 Z-
Last name I-'�! �-+ First Name Middle
street Address_ L2ZALL4zdAgid l.¢. city FE . Ca11� Ins state Co rzip S�oSLS
Cam$ (a0RINFO:CompanyName 60Ld QC6,�r_r�_ ConVacWPhone# g�0�22Gi—�729L
Uc Holder Name City of Fort Collins License # Supervisor Cart #
Moiling Addrw9-L f2y._ E: Et city_ Lam fa,,..d state Co •—•-•. Zp- 4
I.HCrAL INFOt
SubdMsbrdPUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTKI IN NFa Total Building Sq Ft OM mdWhg Wmman! Total Garage Sq Ft
,. _
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg HelghL # Dwelling Units
10 Floor Sq Ft 20 Flew Sq Ft 81tl floor Sq Ft Unfiished 13MA Sq Ft
i
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Beths 3S Ba#re # of Fireplaces
Air Cond/dotiing: YOa
Energy lrt - ( Oft& appro.pdab chohx) 1. ComCheck 2. ResChedc w/AIr Sealing
8. Reach&* w/slower - 4. Simulated Perforinence Aftemative❑ S. Prescriptive w/Alf Sealing B. Ptesaipfive w/ Blower Door
City of Fort Collins Stock Plan # Ust appropriate option Ate
UnLIME@INFOo
Water Tap Size Sewer Tap Size Metered: Yes ❑NQ Temp. Pedestal YesEl No ❑ J
Type of Heat: 11Gas 11Electrtc Electric Main Breaker Size (Residential only) 1:1160 Amp or Less ❑2DO Amp []Other
Value of Construction (Inducting labor material & profit) S / FL 5471,
Dewwlp#on cf Work:-99m&aj9� e� lztco, 2e s-r t. j : A--,ob i-1 KL. L.e
Contact Name & Phone # of JOWWM SUPERVISOR: ����v ie, ..5 off- g4a - 3G,2'z
a9Lb000i�61wOC.,(p�Q:
Electrical Mechanical
Framer Roofing
Plumbing
Concrete Fireplace
Solar Other Ofher Other
Wcant I hereby adumWedge that I have read ration and irate that the above btfon mU= Is aomaot and agree to comply with all requirements
contained heroin and Coy of Fat Cafts ord laws reguiaung building oonsaua#on.
Applicant Signature Print Name _I" t ,J
�- S_ Pnona 9 Z- 35�z
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