HomeMy WebLinkAbout709 Gilgalad Way - Applications/Basement Finish - 09/06/2005City 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 NUMBER �0 5a5%6)� APPLICATION DATE I _U —(,I/
Job Site Address 'Tort v
Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # q%�•�(�j--�3Z�
Last Name f tt First Name G `�t�[ 4- � Middle
�� Street Address l�1 v�.�1 �.b 'r City <1c=0n S StatP? — Zip
� T
CONTRACTOR INFO: Company Name—J{J'tEr Contractor Phone 0 17.o-- Z2-7—A:�, q 2Z
Lic. Holder Name �Y C �� , City of Fort Collins License # +I I Supervisor Cert #
Mailing Address 3�1 S Co�� �>J�R� �"r City��6411%'W5 State �'v Zip�Z
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Total Garage 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-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option
6. Prescriptive w/Blower Door
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 11200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ bi7
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:_
Subcontractor
�Info:
' , C
Electrical "M/fit Mechanical Op1ftm 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 Print Name
Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE