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HomeMy WebLinkAbout1833 Golden Willow Ct - Applications/Basement Finish - 06/15/2009BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 (Aqm�ftm- www.fcgov.com/building City of Fort Collins BUILDING PERMIT APPLICATION APPLICATION NUMBER V , APPLICATION DATE_ t� 0 / Job Site Address 1933 Go. a ,�, wic� cv C7- Unit # PROPERTY OWNER INFO: (All owner information is required - it is not optional) //�� Phone # l 9�0� ZZ.S-bS3Z Last Name /07-E)n f /COiine—x First Name BRE/tJ: C itr�s -7 Middle Street Address /b' 33 GO [_AEn[ ii c [ n , CT City I 6t t- i.. n ' State CC) Zip 6 r j-'QV CONTRACTOR INFO: Company Name /J7Z7-a7C ay;, r Z 43-/4rvContractor Phone # y70 In YO - /,S} S- Lic. Holder Name j/ CvSn-X City of Fort Collins License # 02-2-�/ Supervisor Carl # //8 Mailing Address to/Ob' LVAJF?C n4.j LJf City 14CT (L'c' . s State C0 Zip kP.SZj LEGAL INFO: Subdivision/PUD Filing # Lot # CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Block # Lot Sq Ft Total Garage Sq Ft Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units ls' Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft (T � " # of Bedrooms # of Full Baths 3/4 Baths % Baths # of Fireplaces Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door City of Fort Collins Stock Plan # List appropriate option #s UTILITIES INFO: 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: RASOX9EA-4- �,n/ SH A/[i�ck �s'tz�� %rcF �„s�sifc�n $i4tni�E„iT Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: n% Electrical /ii ,4,e 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 construction. Applicant Signature y Print Name /Tr7+7-y L {ems irX Phone 1� %o / $-:�? Distribution: White -Office Yellow - Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE