HomeMy WebLinkAbout609 DUKE LN - APPLICATIONS - 7/18/2017City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER O APPLICATION DATE JUL 18 2017
Job Site Address V t Lalf Unit #
PROPERTY OWNER INFO:, (All owner information is required - it is not optional) Phone # MCI- 7" 4 ' S70
Last name &Llw First Name "~ _&rLi L( Middle
Street Address tto'q �w� LA^ -A, City State Zio
CONTRACTOR INFO: Company Name OIS4�_ GkII„r(,&j Contractor Phone # 0303 - ` O • I4733
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address 1 65-5-1d, Gj root City ram^ C � W � �� State C-P Zip p0110
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Filing # Lot #_
Block # Lot Sq Ft_
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
2nd Floor Sq Ft
3`d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished 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
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only)
Value of Construction (including labor, material & profit) $ /! D0i7
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
r
1 fin'
Concrete
Other
Temp. Pedestal Yes or No
❑ 150 Amp or Less ❑ 200 Amp ❑ 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 dinances and state laws regulating building construction.
Applicant Signature �/ Print Name rI1 Phone 303 ,►/ �30rP
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE