HomeMy WebLinkAbout1136 Sagamore Cir - Applications/Basement Finish - 03/31/2006BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBERVJ �� 1 APPLICATION DATE3 I 0�0
Job Site Address SCA-AaMOV7t Gt, Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 2-'2-S C C,3
Last Name &Y-&--.1 First Name RLkSS 4 M6W1c11 Middle
Street Address 11',156 Sot,Q/VAQYe, ��" City Et*+ Cc k ( 1 WS StateeC Zip
CONTRACTOR INFO: Company Name Kulen�,K� 6`dQ Inc— Contractor Phone # 31 G & 4&-3-
Lic. Holder Name RCity of Fort Collins License # C -q 65 Supervisor Cert #
Mailing Address '2)-5 h�jV-t City Rr+-C01 k IRS State_ Zip 8_ 1
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft 34-
# of Full Baths % Baths I 'Y2 Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
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 (Resid ial only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
Description of Work: .313>ASC 111e 1 n l S�3 C,0nS►S+-InQ Q 71� 0.
Pam % 11 Coo p Ol 3/9- hash .
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: (` ���
Electrical t ,�,,� Q— Mechanical �� �r(r AUKS Plumbing v ,
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 or finances and state laws regulating building construction.
Applicant Signature Print Name {fit" k Ale—yl�k"' Phone 3 1G b+E 3
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE