HomeMy WebLinkAbout3323 Shallow Pond Dr - Applications/Basement Finish - 07/05/2011t of
LUAU"COMMUNITY EVEL PME T NEIHBCi
1 ` �.S��hns' 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416.2740
wwWallawcom/bullding
BUILDING PERMIT APPLICATION
APPLICATION. NUMBERdMY APPUCATION DATE`l'
Job Site Address 3 3,�3 fHote w R* 17x Unit #
PROPERTY OWNER INFO_ (All owner irKonnation Is required — it is not optional) Phone #
Last.name GOU`�D�Y First Name ANptw W 614ZY Middle
Street Address, 3 �-3 SylW cav AAA City far- CCU-%,rf State C o zip 0665-28
CONTRACTOR INFO: Company Name S� v 9:k104cEy Contractor Phone # �'7v �S3 y- UlS6
Uc Holder Name �TEv� /�NcEy City of Fort Collins License # Supervisor Cert #
Mailing Address i 2Vy N3g0 i� City I�M¢cEy State 60 Zp 60631(
LEGAL INFO. c�
Subdivision/PUP FoSSSc C P/Af }?,•D Filing 8 s� Lot # "Z Block # J Lot Sq Ft f2Ca3
CONSTRUCTION INFO: Total Building Sq Ft (not lnduceng basement) Total Garage Sq Ft.
Residential Sq Ft 576 3 Comm'I Sq Ft # of Stories_ Bldg Height # Dwelling Units .. �/
k 1- Floor Sq Ft $y 1 2nd Floor Sq Ft 3 Floor Sq Ft Unfiished Bsmt Sq Ft 6 7 !
Finished Bsmt Sq Ft 2 a3 # of Bedrooms 4- # of Full Baths -2,- % Baths --L- 'A Baths -L— # of Fireplaces o[_.
Air Condldoning. Ye flN Energy Info-( Circle appropriate dw/oe) 1. ComCheck 2 ResCheck w/Air Sealing 0
S. ResCheck w/Blower Door 0
4. Simulated Performance Alternative❑ 5. Prescriptive wiAir Sealing G. Prescriptive w/ Blower Doofl
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size. Sewer Tap Size Metered: Yes ®NJ7 Temp. Pedestal Yeso No ❑
Type of Heat: Gas ❑Electric Electric Main Breaker Sae (Residential only) ❑150 Amp or Less RM 200 Amp Other
Value of Construction (induding labor, material & profit) 00
Contact Name & Phone # of JOSSITE SUPERVISOR: S-MV E- 9-f9cfy 5$3 9 01566
ElectricalMecha ical +i'�S E�iKr; Plumbing14K
Framer �TEdr� - i�,�/ Roofing Concrete A Fireplace N .
Solar- A(Itt Other Other A" Other
Applicant: I hereby acknowledge that 1 have read this application and state that the above information is correct and agree to comply with all requirements
wed herein and City of Fo Collins ordinances and state laws regulating building construction.
Applicant Signature Print Name 1 CAE PQ71k(fC-ci Phone 'Silo' G1�6
Distribution: White - Office Yellow - Applicant Pink- W W W/Storrrnwster
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE