HomeMy WebLinkAbout520 N Sherwood St - Applications/Basement Finish - 09/15/2005BUILDING PERMITS & INSPECTIONS DIVISION
h14i1lllllllllllIP.O. Box 580 • Fort Collins, CO 8052M580 • Phone: 221-6760
www. fcgovxom/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER �O 3 r APPLICATION DATE q — / O
Job Site Address 5 a,o Qr Vood 3 Unit # 3-5-
PROPERTY OWNER INFO: (All owner information is required — it is notoptional)Phone # ;Za ) —
Last Name I �'C 1� First Name ! / a ✓1 Middle
Street Address_ SA d Al, ad 4 f4 City i Cd 11� hS State L O Zip G S z
CONTRACTOR INFO: Company Name 1 ec jw A r,` o� (,qT-*n4 5 Contractor Phone # -7t'
Lic. Holder Name `D�t/:,�d G 01 d 1'h er4 City of Fort Collins License # _ Supervisor Cert #
Mailing Address_ 10 a: s7 0 a; d � i C3 7 S- City• C e� 11'+5 State C d Zip 8 0 SZ r-
LEGAL INFO:
Subdivision/PUD
Filing #,
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq Ft # of Stories
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Lot # Block # Lot Sq Ft
5-00 Total Garage Sq Ft
Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft ZSO0 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 6. Prescriptive w/Blower Door
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or N
Type of Heat: ,KGas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other /
Value of Construction (including labor, material & profit) $ 0 0
Description of Work: ei c4 ,` 9 ( 6 ci s Q ri ,d
2
Contact Name & Phone # of JOBSITE SUPERVISOR: 5 ci oe Is
Subcontractor Info:
Electrical frrMhok Mechanical Q r'l Plumbing R Q Yh
Framer 5e ( ` Roofing Concrete Other
Applicant: I hereby acknowledge that ave read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City Collins o 'nances and state laws regulating building construction.
Applicant Signati'ire Print Name Dty,ij 13 h J� ► Phone
C_ _._
&i1PPUtLrcAT,ON
: White — Office Yellow — Applicant Pink — WWW/Stormwater
T EXPIRES 90 DAYS FROM APPLICATION DATE