HomeMy WebLinkAbout2832 Outrigger Way - Applications/Basement Finish - 03/31/2006City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER v APPLICATION DATE
--Job Site Address Unit #
-p.PROPERTY OWNER INFO: (All owner inform5tion is required - it is not optional) Phone #
Last Name /L�%��' First Name Middle
Street Address City�State e�o'• Zip
', /RACTOR INFO: Company Name Contractor Phone #
Lic. Holder Name City of Fort Collins License #.
Mailing Address City,
L INFO:
Subdivision/P Filing # Lot #.
Total Building Sq Ft (not including basement)
Residenti�q Ft Comm'I Sq
1st Floor Sq Ft _11�_ 2nd Floor Sq Ft
# of Bedrooms -'-#.Qf Full Baths
Air Conditioning: Yes No
3. ResCheck w/Blower Door
4. E-Star w/Blower Doo
City of Fort Collins Stock Plan #
1M `"
UTILI INFO:
Water Tap Size Sewer Tap Size
Supervisor Cert #.
State Zip
Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
_ Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
_ % Baths '/2 Baths # of Fireplaces
appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
\5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List approprl tion #s
Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only):
0 150 Amp or Less ❑ 200 Amp ❑ Other
,..Value of Construction (including labor, material & profit) $ J % f V
,a. Description of Work: �_S&_,ne,,L 7L ��u✓ b�r� V "'1'>US111—
T.Contact Name & Phone # of JOBSITE SUPERVISOR: _ /G rl Z4j-/xx.''5--j
Subcontractor Info:
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 of Fort Collins 9rdharijeesend state laws regulating building construction. /
Applicant Signature �—�' Print Name_,,_Va ?7"iLi�S Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE