HomeMy WebLinkAbout622 LESSER DR - APPLICATIONS - 8/10/2018City of II 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 �) 1 vt)U U b APPLICATION DATE '6 I C) I I -CJ
Job Site Address(12Z7— t-esCer 0(U,ye— Unit #,
PROPERTY OWNER not optional, - // ) Phone # /0 (".1 0
Last name Lam/ YI ✓✓� t' PT f \j A rFirst n-h
Name I z-T' t p �� Middle �
Street Address City State W Zip OS u'
CONTRACTOR INFO: Company Name -r 2) p Contractor Phone #
Lic Holder Name
City of Fort Collins License # Supervisor Cert #.
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) --�D o Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1 s' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/< Baths '/2 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 & profit) $ k Lp !z='
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR: 2aj PL/" l ��
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 FF* Collins ordinanc and state laws regulating building construction.
Applicant Signature Lam/ Print Name�� �!'fi'/T"r� Phone
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE