HomeMy WebLinkAbout913 BENSON LN - APPLICATIONS - 4/20/2017City
}off I 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 IE5 1 7 02-OY/ 6 APPLICATION DATE April 20, 2017
.lob Site Address 913 Benson Ln FTC 80525 Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name Austin First NameWilllam Middle D
Street Address 913 Benson Ln aty Fort Collins State CO Zip 80525
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
Contractor Phone #
City of Fort Collins License #,
City
Supervisor Cert #
State Zip
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
151 Floor Sq Ft
2n0 Floor Sq Ft
3ra Floor Sq Ft
Unflished Bsml Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/. Baths % Baths # of Fireplaces
Air Conditioning: Ye&n Energy info: ( Circle appropnate choice ) 1. ComCheck 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door ❑4 Simulated Performance Alternative❑ 5. Prescriptive w/Air Sealing11 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[:]
Type of Heat Gas ❑Electric Electric Main Breaker Size (Residential only/)I ❑1
Value of Construction (including labor, material & profit) $ , -7 z41.
Description of Wo
Taking down
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Temp Pedestal Yes❑ No❑
Amp or Less E1200Amp 0Other
Plumbing
Fireplace
Other
ng.
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 o ces s to laws regulating building construction
Applicant Signature ' Print Name 1,/�jrG=+-t Phone 9�U Fn'j�
Distribution White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE