HomeMy WebLinkAbout6714 ANTIGUA DR - APPLICATIONS - 12/6/2017City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort+t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
Job Site Address G-4 I q f\r- t GUUnyiit # 41
PROPERTY OWNER
+ INFO (All owner information is required - it is not optional) Phone # `- V - a 13^� 7 I
Last name V Lk- LJI'10�rnvs-Q, First Name C � -C' Middle f"C
Street Address Gam City 4::��l COWAS State w Zip -0 5
CONTRACTOR INFO Company Name
Lic Holder Name
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO: !� 1
Subdivision/PUD J' �� rOt t�f Qe �L Filing # I Lot #—qi— Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
i
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
2nd Floor Sq Ft
31 Floor Sq Ft
Unfiished Bsmt Sq Ft LIS
.#Finished Bsmt Sq Ft 555 # of Bedrooms I # of Full Baths 3/. Baths ]-- '/z 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 Temp Pedestal Yes or No
Type of Heat kGas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $aO t 000—
Description of Work'&SPrr.'eiL 't' risk ^ k6cii-Ifo[)n-, rpoN k Gpn, 60 ,
Contact Name & Phone # of JOBSITE SUPERVISOR: Cr»ri2. s t. rye_ I n — Q_1 3 — -I q (,, I
Subcontractor Info:
Electncal)(&Ar%os4fG6UHMechacal(=&r!iLo" Plumbing1\ ,Plv,.
Framer Roofing 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 a?e..(�L
y of Fort C ordinances and state laws regulating building constructio
Applicant Signal ,i Io�,J�. l AGA^--51 - Print NamC-6f l:bu CAt(tf M e-Phone t>40" 5
Distribution White -Office Yellow -Applicant Pink - WWW/Stonnwater�
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE