HomeMy WebLinkAbout4130 SPRING CANYON CT - APPLICATIONS - 6/15/2017City of
/110,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
APPLICATION NUMBER 'b I ' / O 3., 1
Site Address LfI 31D U(I
BUILDING PERMIT APPLICATION
APPLICATION DATE I ' I `% /7
nit #
*ROPERTY O JW��N��E/�R�I�NF�O. (All owner Information Is required- It is notoptional)Phone # 7 �0 '�o ' Q S� 0
Last name /ivt'i/l First Name at'%T tt/ d& Middle
Street Address q130 Cityi- a &rIJ State CU Zip .ra-J—
Jt CONTRACTOR INFO Company Name ✓&A Ud T� L0I0 Contractor Phone # 0120 —23 7—aba6
Lic Holder Name G ka 1 i t / f 1 j I� ! City of Fort Collins License # Supervisor Carl #�
Mailing Address y1t Ovnno Drwf CityFL LbII1AJ StateCD Zip A)rjLA
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
161 Floor Sq Ft
Finished Bsmt Sq Ft
Air Condidon►ng Yes No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2n4 Floor Sq Ft
# of Stones Bldg Height # Dwelling Units
31" Floor Sq Ft
# of Bedrooms # of Full Baths
Unfiished Bsmt Sq Ft
% Baths '/z Baths # of Fireplaces
Energy info ( Circle appropriate choice ) 1 ComCheck 2 ResCheck w/Air Sealing
4 Simulated Performance Alternative 5 Prescriptive w/Air Sealing 6 Prescriptive w/ Blower Door
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 8 profit) S 1 - 1
11) wo 00
*Descnption of Work Ill CCl ( p Lei
Contact Name & Phone # of JOBSITE SUPERVISOR
Subcontractor Info,
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 Fort Collins ordinances and state laws regulating building construction �J� /[
*Applicant Signatur " Print Name Linda Lb(, V 4 Phone
Distribution White - Office Yellow -Applicant Pink - W W W/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE