HomeMy WebLinkAbout3230 CREEKSTONE DR - APPLICATIONS - 7/6/2017City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Forrt Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
"�,• 7-ro -20 i7
APPLICATION NUMBER �/l � � rr I" - - � APPLICATION DATE
Job Site Address jan CRtt1CS� rnn-( E sF, FT . 4f oL.1-- c. Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 170 - 02 z3 - 95?'8
Last name KA UF0fAt4 First Name ALP 14 Middle
Street Address 1, *6 'DPZ City F7-. 60C-L16S State Ca zip 9365ZS`
CONTRACTOR INFO: Company Name /G/OvYES F"Af T(4-E /-AiZ-r Contractor Phone # Q76 - Z.(-7
Lic Holder Name C' tw 1 rF(702D k1 . NAAT City of Fort Collins License # Supervisor Cert #
Mailing Address 'S7� Lcst r 12s4SS CT' City FT_ dGc-t-(-�-tS State t"O zip
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
151 Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2"d Floor Sq Ft �'t02 Eats Z 3r1 Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths Yz 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 #s
Water Tap Size, �}� lS ( Sewer Tap Size r�x t ST Metered: es r No Temp. Pedestal Yes o No
Type of Heat: gGas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
OV
Value of Construction (including labor, material & profit) $
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical (6EC Mechanical �� Plumbing (�Q &OAATE ALdrejWA6
Framer NawtiF5 FKL)Af -&15 t oof ni g F+ /.4 Concrete Fireplace
T
Solar jl//'} Other '41 1A 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 124 1 F FOrAD /,/ AM kT' Phone c/70 -.:;Z l7 -.2`t 33
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE