HomeMy WebLinkAbout4267 Stoney Creek Dr - Applications/Basement Finish - 06/11/200816)-7 (aII
BUILDING PERMITS & INSPECTIONS DIVISION 1101P.O.
O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.conVbuilding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER r"v R/l`X�035q � APPLICATION DATE Co,
I I
Job Site Address tj Zb+ S {ACy CAQe L Dr)wv-+; Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #
Last Name 12"&C& First Name 'irMiddle L -
Street Address 4 2 6+ 5 ti CR.,?.e L D r . I city ii' Ld l l f A is State LJ Zip JCS L�
CONTRACTOR INFO: Company Name
Contractor Phone
Lic. Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1 st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# of Bedrooms # of Full Baths % Baths % Baths # of Fireplaces
Air Conditioning: Yes 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
Water Tap Size Sewer Tap Size 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
Value of Construction (including labor, material & profit) $ a405-_ W
AIA 4-
Contact Name & Phone # of JOBSITE SUPERVISOR: ph,ax c % l 36 Ld
Subcontractor Info: D ' 6 Electrical —r (*-. b t��Y1C_. Mechanical Plumbing �A'�y I /�-62')
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.
Applicant Signature Print Name Phone
Distribution: White — Office Yellow —Applicant Pink — WWW/Stonnwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DAT