HomeMy WebLinkAbout1509 Briarwood Rd - Applications/Basement Finish - 07/09/2007BUILDING 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 f APPLICATION DATE
--Job Site Address /Soct Frie ,ewoels ,k06( Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # q-7o - If Oa-5-5-6" F
Last Name CeurISO, First Name .TSwaS Middle
Street Address aI SDc( 8r;r, r wow City rz Cor'C , s � State CIS Zip'?05
—CONTRACTOR INFO: Companyt-Name �� coy poci N,t ; Contractor Phone # q'To ? a'l I''I'7 S
Lic. Holder Name�vI(A rfcun1C Ivt City of Fort Collins License #"J-5`1) Supervisor Cert #
Mailing Address l6a�( Q� <�, P S s City rat Co ( ii ✓, eState eO Zip �'OSa'7
LINFO:
Subdivision/PUD Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
1s' Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
b74LMES INFO:
Water Tap Size S1
Comm'I Sq
2nd
# of Full Baths
Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
_ Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
_434-Qaths /2 Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1�6omChec
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
Type of Heat: ❑ Gas ❑ Electric
List appropriate option
Metered: Yes or No
Electric Main Breaker Size
2. ResCheck w/Air Sealing
ptive w/Blower Door
Temp. Pedestal: Yes or No
or less ❑ 200 Amp ❑ Other
O'Value of Construction (in din laboy mate ' 1 & rofq it) _$ CA 09
p f� µ� t�yc' ca �o+r�+1 f�1
Description of Work: KeC ttoo eA40vr Cstn 6et1; :nle's- Remove, EXi� i L; J
QcQ k e.,^ 1-4a1Ck Cep\:In in5+C,I( �('yw41)
CQ;;ic.P- JRe.Mo✓e. PA'Ne-l*na F-Vf GKrK o1)c4 0�i.e+5
(2ewxove d- Repi �ce, h4:-es r iVA<u`ale- ply., j& 5ke�t rar<
wlnc�lP. i�Sv%n4- Ce. is Fvr �okrt�
Contact Name & Phone # of JOBSITE SUPERVISOR: ]De' v . I..^mow /(1 r` a
Subcontractor Info: .. //�^t �/d
Electrical yj2pe s ElecAf.0 �1 �Z Mechanical
/ AIA Plumbing AIA
Framer 41A Roofing / r' A- Concrete /y `A Other
Applicant: 1 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 o ii'nanceejF, and state laws regulating building construction. r
--Applicant Signature / �Giwt tl �� Print Name�di r f- ^a'^ k 1 tyl Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE