HomeMy WebLinkAbout7220 Randolph Ct - Applications/Addition or Alteration - 05/15/2009BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
CityofFort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER �v ;Z— APPLICATION DATE
Job Site Address _qZzo Gard o l�, �. Cf, Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 4�0 • Z2��1 2y O
Last Name M- &o-c < First Name M • 1�-_,, Middle
Street Address _4Z7_0 City 57t. (.0W,> State CO Zip gofZ-(�
CONTRACTOR INFO: Company Name Go^s+rti+- ,9^ L4eContractor Phone # 4;�° 'ti t 2--41 ZQ 9
Lic. Holder Name J ° r� S+o --'I'o City of Fort Collins License # Supervisor Cert # 2 S
Mailing Address ITrKXu_r. 't>('. City ;:+. CC, II ,•.s State (-o Zip 305-Z
LEGAL INFO:
Subdivision/PUD �Q q`T J`q1+- 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:
Block # Lot Sq Ft
Total Garage Sq Ft
Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths % Baths '/2 Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Starw/Blower Door
Y
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) $ !D, 00
Description of Work: �M o al4_1 w.0 c tee. loaf 1.roo �. - C_V.-.v "I -\- 61 c \�Qli 1. b
b LJ � G. n
(2s d+ roxa_4 -10 (Al �.. Or, S130.4
4. 'Z01,6 ��.nnorc� w.-���.✓ edt. Sl..cw�r.
Contact Name & Phone # of JOBSITE SUPERVISOR: S0.r`,A 4i� o- `t �-L- r{ za9
Subcontractor Info:
Electrical K f? E. l e c_+r-: c- Mechanical Fro,.:t V_,_ j Plumbing L f F E4cLA2r ,se.i
� }a
Framer DSL L&,,,4r-.ck:o.. (D A' cRoofing 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 h., v Print NamePhone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE