HomeMy WebLinkAbout1909 Silvergate Rd - Applications/Basement Finish - 01/11/2008BuitAING 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 V Ll APPLICATION DATE
Job Site Address/ g 09 Unit # pp
PROPERTY OWNER INFO: (All owner information is required - it is not optional)) Phone # 9729 -9 W `372 2-
Lost Name 9A-mIne.re.,- First Name �O!'11��a Middle �/1 �
Street Address 1909 09 �/ [ //e ✓�l _ city ir4- �nl 1 State W Zip ?D
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cart #
Mailing Address CityState Zip_
LEGALINFO: Subdivision/PUD OL"e-✓/ODK C k/avd � Filing # 3lr Lot #—&_ Block # Lot Sq Ft 3#
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) O? 47 Z%P Totai Garage Sq Ft 41Z.Y
Residential Sq Ft Z q2-4 Comm'I Sq Ft # of Stories �7 Bldg Height # Dwelling Units
1e Floor Sq Ft /2 37 2nd Floor Sq Ft 13 Unfinished Bsmt Sq Ft 57& Finished Bsmt Sq
# of Bedrooms _ 3 # of Full Baths Z % Baths Y2 Baths # of Fireplaces
Air Conditioning: es No Energy info: (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 Metered: Q or No Temp. Pedestal: Yes or No
Type of Heat: 0 Gas
Value of Construction I
Description of Work:
❑ Electric
❑ 200 Amp ❑ Other
Electric Main Breaker Size (Residential only): 0
/150 Amp or
Contact Name & Phone # of JOBSITE SUPERVISOR: -z2j L 97p--� �d "37ZZ
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
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 o Collins ordinances and state laws regulating building construction. Applicant Signature 27"U- Print Name ✓1 � er�� Phone �ZK`291? ��ZZ
Distribution: White — Office Yellow —Applicant Pink — WWW/Stonnwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE