HomeMy WebLinkAbout620 HILLVIEW CT - APPLICATIONS - 8/21/2014City of
F,. o�rt Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building 1,
BUILDING PERMIT APPLICATION
APPLICATION NUMBER I I LOto0O APPLICATION DATE
Job Site Address Unit #,
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # g%D —'Ap 5 �
Last name C�Y//G'�% Sei V First NameMiddle
Street Address 6.;2/9 //Ui Pi1/J C,7 / /City d Y ,����/ �_ Statea� Zip O�
CONTRACTOR INFO: Company Name/y7�,�/Cc/ Jzem4/C ntractor Phone #
Lic Holder Name 4
�'+� / City of Fort Collins License # Supervisor Cart #
Mailing Address 1l�Dd Q`11,f , S� City //GSA /JP/t. State Zip
LEGAL INFO:
Subdivision/PUD ,�C'P�YL. JyVz111r Ca
,62 �Z,_ Filing # Lot # Block # Lot Sq Ft T// liiC/PS
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) A3 ; Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/< Baths '/2 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:
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) $ 341elJ- eo
Description of Work: [ 1 i`/� %yJGI�e / % '%l% e9 7AI&w
Contact Name & Phone # of JOBSITE SUPERVISOR: T /"ZZK ,�eJt/ 7 G/ 7S
Subcontractor Info: /V-I*W
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
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 Fo Collins ordin nces an state laws regulating building construction./J
Applicant Signature, �� Print Name 4/ . C ail �fi7a /Phone 770-7 G/%S
Distribution: White —Office Yellow —Applicant Pink—WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE