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HomeMy WebLinkAbout449 Flagler Rd - Applications/Basement Finish - 02/10/2006BUILDING 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 ,ere (a�j'/ APPLICATION DATEA) --e� Job Site Address L44q WdA te, PJ fiNVkqGCL, Unit # PROPERTY OWNER INFO: (All owner information is required — it is not opti-offn��al) Phone # QJ() Last Name C©©I'-.i2, First Name_ lr6 f1 Middle . Street Address 4 (A City � State Zip �5� fty� CONTRACTOR INFO: Company Name t T _ Contractor Phone # Lic. Holder Name Mailing Add Su City of Fort Collins License #. City_ Filing # Lot #. Total Building Sq Ft (not including basement) Residential Sq Ft — N Comm'I Sq 1st Floor Sq Ft N # of Bedrooms Air Conditioning: Yes No Supervisor Cert #. State Zip. Block # Lot Sq Total Garage Sq Ft # of Stories Bldg Height # Dwelling Units Floor Sq Ft Unfinished Bsmt Sq Ft NfFinished Bsmt Sq Ft 7?;�Qy— Full Baths % Baths 'Y2 Baths # of Fireplaces En y info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealin 9 3. ResCheck w/Blower Door 4. E-Star w/dower Door City of Fort Collins Stock Plan # UTILITIES INFO: Water Tap Size Sewer Tap Size 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door List appropriate option #s -Metered: Yes or No Temp. Pedestal: Yes or No Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less 11200 Amp ❑ Other Value of Construction (including labor, material & profit) $ / /. Description of Work:_ 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 coon(strruction./� (�, p� —1 Applicant Signature ` V) (a U�U Print Name I�l iQkn 1. Qa\U Phone �i�� . (4&d -4�� 1 Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE