HomeMy WebLinkAbout3715 Shallow Pond Dr - Applications/Basement Finish - 07/24/2006City 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 NUMBERbO V APPLICATION DATE!
Job Site Address 3-1t5 SV1A)1M,0 VbnQ br. F+. (.olj jns Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # aaLO-S7/ a'
Last Name � First Name LeL rrV `� lJ� rl S Middle
" Street Address 3(]b RLX' cq P-, City Ft. Co I I n 5 State- _Zip gOGv.
CONTRACTOR INFO: Company Name
A, Contractor Phone 3p-3
Lic. Holder Name RC7Y, T C-k' Or'— City of Fort Collins License # 2-7-2—Supervisor Cert #
Mailing Address %10 li n nova rm -Dr. "' ( City ff. 62P iV S State1f o Zip 0
LEGAL INFO:
Subdivision/PUD
Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft
1st Floor Sq Ft _
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Comm'I Sq Ft.
2nd Floor Sq Ft
# of Full Baths
Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
3/4 Baths '/2 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 (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical pj on ee c Mechanical l fflGc�" -k-'-A c Plumbing Tk-j Q(—
FramerRoofing 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 off Fort Collins ordinances and state laws regulating building construction. %' /
Applicant Signature r ( Print Name 7&i 2 l-7Pr1 / 1 Phone c;) c0 J- o^%�
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE