HomeMy WebLinkAbout5132 Cinquefoil Ln - Applications/Basement Finish - 04/30/2009/ BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
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Cit *Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 6IW07M APPLICATION DATE 4. -,7vV , 0 /
Job Site Address 03;1 C It K9 Unit #
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PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # I
Last Name �t4-� <�',P First Name T ; `/ Middle
Street Address J 3 C,`,, u,P �L h City cc�, 1 r State Zip
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CONTRACTOR INFO: Company Name R1. �„ CuS s %p` o actor Phone #
Lic. Holder Name !; /e City of Fort Collins License #�� 0 Supervisor Cert #
Mailing Address 3D3� ti✓ h2, ,� s/� City /� C•//,k 9 State 0 Zip_$US.2
LEGAL INFO:
Subdivision/PUD
Filing # Lot #.
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq Ft # of Stories
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Block # Lot Sq Ft
Total Garage Sq Ft
Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# of Full Baths 1/4 Baths '/2 Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
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) $ a� , ) U�
Description of Work: / f1 *k 1, S b oL ^ i �, b �e S r rg ,e Ak 71— y49
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical
Framer
Roofing
Plumbing U1.vb.cX--
Concrete 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 For ollins ordinances and state laws regulating building construction.
Applicant Signature Print Name -fin Pe-le��-SeA Phone -�Lg'7— P7!R
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE