HomeMy WebLinkAbout4209 Lookout Ln - Applications/Basement Finish - 05/03/20055. Prescriptive w/Air Sealing
List appropriate option
# of Fireplaces
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
Metered: Yes or No Temp. Pedestal: Yes or No
❑ Electric Electric Main Breaker Size ((RResidential only): ❑ 150 Amp or Less 11200 Amp ❑ Other
oludina labor. material & nrnfitl t % T)
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins CO 80522-0580 • Phone: 221-6760
6ZI www.fcgov.com/building
Citvof Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
Job Site Address L4 7-o°k L aorec o k L %�, Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # VT�
Last Name �th C� First Name_L t </tati� �Clwv J, Middle
Street Address L1200% L.po Woo City &ar� CJM , v, J State C—o Zip
CONTRACTOR INFO: Company Name
Lic. Holder Name
Mailing Add
Contractor Phone #
City of Fort Collins License #
City
Supervisor Cert #.
State Zip
-
LEGAL INFO:
Subdivision/PUD
Lot #.—'
Block # Lot Sq Ft_
CONSTRUCTION INFO:
Total Building Sq Ft (not including basement)
Total Garage Sq Ft 4010
Residential Sq Ft
list 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 # of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft /ft4 Finished Bsmt Sq Ft _
# of Full Baths L % Baths '/z Baths
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door
Water Tap Size Sewer Tap Size
Type of Heat: ❑ Gas
Value of Construction
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
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 ollins ordinances and state laws regulating building construction.
Applicant Signature «('6— Print Name
Phone ?0-��D JT-
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIPES 90 DAYS FROM APPLICATION DATE