HomeMy WebLinkAbout3310 Shallow Pond Dr - Applications/Basement Finish - 04/20/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
66 www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER O 3 APPLICATION DATE_/
Job Site Address
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PROPERTY OWNER INFO: (All owner information is required - it Is not optional)
Unit # j
Phone # 970 -- -339 1
Last Name_ First Name ^lt In �C0.-4% Middle
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Street Address City State Zipl�_
CONTRACTOR INFO: Company Name CIYrtractor Phone # 76 2pZ
Lie. Holder Nam ity of Fort Collins Licce�enseff #I Supervisor Cert # � S�
Mailing Address — CityTH
gyp\ � I UISState �C7 Zip g0`C? to
LEGAL INFO:
Subdivision/PUD c �� Filing # Lot # _ Block # Z Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Comm'I Sq
2nd Floor Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
Unfinished Bsmt Sq Ft
# of Full Baths 3/4 Baths /z Baths
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
Water Tap Size Sewer Tap Size
List appropriate option
_ Finished Bsmt Sq Ft iOgO
# of Fireplaces
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 20O Amp ❑ Other
Contact Name & Phone # of JOBSITE SUPERVISOR--t)I)e—S!-L(--fir
Subco or Into:
Electrical Mechanical V L LQSPlumbing U—M VN-1au' kQ4
Framer
Roofing
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 Fort Collins ordinances and state laws regulating building construction. t
Applicant Signature Print Name--.J \�{er Phone -U -3(0
Di rib tion: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE