HomeMy WebLinkAbout3821 Sky Gazer Ln - Applications/Basement Finish - 09/04/2009BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www fcgov.conVbuilding
CityofFort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER ii p 1114 U 12 V 7 APPLICATION DATE 0 l 10 LY11-I i 1
Job Site Address ` � Sk5,� a&,r Lr, Unit -# A
PROPERTY OWNER INFO:m (All owner information is required - it is not optional) Phone #
Last Name �t�C_C ?� L First Name 1 Middle
Street Address �� City �� 1 �1'MS
State, CO
CONTRACTOR INFO: Company Name i;� J Ucq I IZEs Contractor Phone # -I z6 " ` qi
Lic. Holder Name_ t'C_ NI _S City of Fort Collins License # Supervisor CertfRq 7 7-61
Mailing Address l N R"06& a City � I I' S State (" Zip
LEGAL INFO: 11
Subdivision/PUD's \d�p \
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Block # Lot Sq
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
I si Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths % Baths Y 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): ❑ 11500 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ .��D . L& . rtTi
Description of Work: r-4n
Contact Name & Phone # of JOBSITE SUPERVISOR:
6(70_H93-K1,
Subcontractor Info:CO-
Me-,
�/�Electrical / ! �1 � _e_cC nL Mechanical � tns r fCf�ZV�, 4's YPlumbing Rf M t V14-01c L
Framer 6,04- cST12ut;Ty)2FSRoofing h Q-- 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 Ci o Collins rdin ces and state laws regulating building construction.
Applicant Signature nt Name ���L ePhone -f (,(JJ -1 3�
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater��