HomeMy WebLinkAbout609 DUKE LN - APPLICATIONS - 12/18/2017City 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 bM O IV (4 ILA APPLICATION DATE 19 Iy 11
Job Site Address aq 1—,Kl Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name n / % First Name �iP/�/-/ Middle
Street Address 40 9 �%Llll'!�:: I City hi-;� State_ azlp_ p t:
CONTRACTOR INFO Company Name h/�T/,( P_Tl ✓C Contractor Phone # 970
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address �� . .2 Jlf Z20 S State1�7Z)l Zip 7
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 _
1s' Floor Sq Ft
Finished Bsmt Sq Ft
Comm'I Sq
2nd Floor Sq Ft
# of Stones Bldg Height # Dwelling Units
3r° Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/, 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 #s
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 & profit)
Description of Work
Contact Name & Phone # of JOBSITE SUPERVISOR: z��i4d �,Q• 9 X�2 - �� 7-�?1 %0
Subcontractor Info:
Electrical
Framer
Solar
Mechanical
Roofing Concrete
Other Other
Plumbing
Fireplace
Other
Applicant I hereby acknowledge t t I have read thi pplication and state that the above information is correct and agree to comply with all requirements
contained herein and Cd of F �ollins r fan s R6 state laws regulating budding construction
Applica i nature Print Name ice^y Phone -
�`' ii�%P1as 1��
Distnbuti White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE