HomeMy WebLinkAbout430 DUNNE DR - APPLICATIONS - 5/8/2018City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rt 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 `IL 3D DLL41 n.2, ►^. Unit #
PROPERTY OWNER INFO- (All owner information is renuired -it is not ootional) Phone # 7 /O Z 23 - 758 I
Last name r_'0 )Eh't.c�if"1 First Name I� /' Middle 1 /
Street Address 4,M Au nn6 Dr . City �Y * W (&A S State L"�a Zip 9'0572 S
CONTRACTOR INFO: Company Name owr�_w Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address
LEGAL INFO:
Subdivision/PUD
City
State Zip
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
1 st Floor Sq Ft
2nd Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
31d Floor Sq Ft
Unfiished Bsmt Sq Ft 'f 2 ( �i 2
Finished Bsmt Sq Ft � # of Bedrooms I # 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) $ 101I0 a
Description of Work: )?4MVd4Ltd 5ectroom 4- _3Anreyot , AP. 0 b&M%rV0?Z '17X s,
140-4AI tAJ&J/s.-1�l.�nrivl4.
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Mechanical
Framer Roofing Concrete
Solar Other Other
Plumbing Raf-r/*ck
Fireplace J
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 ,c. �D7.t} Print Name Ik/�� ai"1 C�IJGI 6761 ! Phone? 70-2�3 ` `75el
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE