HomeMy WebLinkAbout509 Sedgwick Dr - Applications/Addition or Alteration - 10/11/2006BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER � � O I APPLICATION DATE / 0' / I — 1W
Job Site Address -5—p q p rah [�)Z Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 970 -3q,� %- 1R3 7
Last Name 1 First Name /� x Middle
Street Address S �j /+ Citye� �J„t�.� State Co - Zip 6-:S;9-
CONTRACTOR INFO: Company Name J7/JJ�aJ C e> rJS-�` Contractor Phone # 9 �?p - �� 3179
Lic. Holder Name lQA-)G:l// W),{)70—,y City of Fort Collins License # 14 Ad Supervisor Cert #5e:5>'
Mailing Address 3 %d `7 SZ:> City czl_t /�s)-IJ� State r_1Z , Zip_�6
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) �!('1 �� l,U6 Total Garage Sq Ft G'7 $ wG
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths /2 Baths # of Fireplaces
Air Conditioning: Yes Energy into: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size 94_1_ 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
I�;-r 6 /
Value of Construction (Inc u mi labor, material & profit)
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
]j )�-c Y,rL 6�RfjQchanical Plumbing
Framer 1Z%�5A> 6>A-> Roofing JUR Concrete s 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. � / p
Applicant Signature �� pS • Print Name 14AIW L . J / D � Phone '7`G .I -
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE