HomeMy WebLinkAbout6944 ROSEMONT CT - APPLICATIONS - 8/8/20140b, 35
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER BI j V75�0 APPLICATION DATE C 19 11
Job Site Address RS e Irmo C+ > Jch 611,12s Unit #
jet "L�' nn
PROPERTY OWNER INFO: (All owner information is required - ittii's/not
optional) Phone # r7 (�
Last name ��E'As" Q �, L / First Name �I-e.Ur1�04 �tFdfrr�l� Middle
Street Address (O I -I 4 -Aenno� i l0u! - City -i v.r L7I t',qS . State C-O- Zip �S z
CONTRACTOR INFO: Company Name 1Y1lse"iq�� T7i'.*IShFiJS.UC Contractor Phone# ,/70-931u'1i9GQ
Lic Holder Name llb�l L rin' City of Fort Collins License # 'rl b ZSupervisor Cert# io r7U7-
Mailing Address P, 0 &rZ Z//z �i City For � G(fa15 State L8 Zip I
LEGAL INFO:
Subdivision/PUD Filing # Lot# Block# Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
is' Floor Sq Ft 2n° Floor Sq Ft 3itl Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/z Baths # of Fireplaces
Air Conditioning. Ye�]Nop Energy info: ( Circfe 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 # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes ❑No❑ Temp. Pedestal Yes[] No ❑
Type of Heat ❑Gas ❑Electric Electric Main Breaker Size (Residential only) ❑l50 Amp or Less ❑ 200 Amp []Other
Value of Construction (including labor, material & profit) $
Description of Work: Ij A& r/ e-&V-
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical)pp Mechanical Plumbing
Framer.AmNr;ucn �'eArvk',4 cofij l l RO 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 ordinances and state laws regulating building -construction.
Applicant Signature '/., \ Print Name (r' ,, j te'/s P,n Phone g
Distribution: White -Office Yellow -Applicant Pink-VWM/Stonnwater
1ra95 APPLICATOON EXPORES t80 DAYS FROM APPdOCAVUGH DATE