HomeMy WebLinkAbout2262 Marshfield Ln - Applications/Basement Finish - 01/22/2008BUILDING PERMITS & INSPECTIONS DIVISION 4104 /, 93
f P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 ✓ ��
www.fcgov.com/building
C'lti>nfFnr+C'nlhnc BUILDING PERMIT APPLICATION
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APPLICATION NUMBERz 9b�ytz>12�t-/�f In APPLICATION DATE
Job Site Address Z 'Z V Z
Unit #
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PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ��'('� (O� _ �1 U
Last Name i
First Name &-yu ou-i 0 Middle
Street Address ZZ(P Z �/\Q j�c�-1
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�� ��L City rl-(fall i f 5 State/���(J Zip t905
CONTRACTOR INFO: Company Name
Contractor Phone #
Lic. Holder Name
City of Fort Collins License # Supervisor Cert #
Mailing Address
City State Zip
LEG A NFO:
Subdivision D
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTIO FO: Total Building Sq Ft (not
including basement) Total Garage Sq Ft
Residential Sq Ft Comml Sq Ft
# of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft 2 loor Sq Ft
Unfinished Bsmt Sq Ftnished Bsmt Sq Ft
# of Bedrooms # of Fu aths
3/ Baths % Baths # of Fireplaces
Air Conditioning: Yes No Energy i
: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower or 5. Prescriptive w/Air Sealing 6. Prescriptive wlBlower Door
City of Fort Collins Stock Plan #
Li ppropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size
Metered: or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential ): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 9 (' T
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Mechanical
Plumbing
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. G 1_
Applicant Signature��yvl 0 J �U w`l Print Name A 6-Phone I To -103 —Tq )8
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FRRR8M APPLICATION,DIA�E