HomeMy WebLinkAbout618 Sydney Dr - Applications/Reroof - 07/21/201407/21/2014 09:42 9705930124 GOLD ROOFING INC PAGE 01/01
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fart Collins =1 IL roll"e p%ve. • Fwt Cdplme 00 80524 • Phonw. 970-4164740
wwwrf6gov com bundlns
BUILDING PERMIT APPLICATION
APPUCAMON NUMIMP APPucATtow oATe
Job Sits Address_ (o I g Unit #
PROE!MM OMME1RtI!NFO, (An owner Imomtatlon Is required - it Is not apnond) Phone # ( *%� - ,L//]
Last name S fop ,Tit First Name. a � a �—Middle- /V lA �,
Street Address /� City l" c4d 1► h Stste_LQ&xip &55
CONTRACTOR INFO: Company Name f� ri j l � oC7 ► X�g 4Convector Phone # Ci 2 6 -F_ jj 4
Lic Holder Name % a 1A, l, n tYTi -r, v X), c- -P City of Fort Collins License P& /.3 47 Supervisor Cert#
Mailing Address I Li }H C- . g ; S j&r. k MAt&K Clty]-•u vg ,.,1 State Q I D .,, zip g'o S3
iat_,cC _11I1;1;rq
SubdMalon/PUD Filing # Lot #, Block # Lot Sq Ft
CS?N=UCXi INFO_ Total Building Sq Ft (not induding basamentl jjL) n Total Garage Sq Ft r. c,&j
Residential Sq Ft 11� Comm'[Sq Ft # of Stories Bldg Height __ f► Dwelling Unite
1" Floor Sq Ft 2n0 Floor Sq Ft 3m Floor Sq Ft Unfilshed Ssmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths % Baths # of Fireplaces
Alr. Condttloning: Ye�d Energy Info: ( Chafe appropriate choke) f. ComChedk l] 2. ResChack w/Air Sealing
11
9. ResCheck w/Blower Door 4. Simulated Performance Alternative❑ S. Prescriptive w/Air Sealing 6 Prescriptive w/ Blower Door,]
Cry of Fort Collins Stook Plan N List appropriate option f/e
UTILITIES INFO,
Water Tap Size Sewer Tap Size Metered: Yes allo❑ Temp. Pedestal YeaD No ❑
Type of Herat: 11 GAS ❑Electric Electric Main Breaker Size (Residential only) [160 Amp or Less U 200 Amp FlOther
Value of Construction (including labor, materiel & profit) 3_ W 2 e,
Description of Work: La _ rh ►t.i-e ! 1. Gia-C .4 O✓m b ►1� 4Tr. !� �, t 7.e i .Yr..n � � ►Yta�w
Contact Name & Phone # of JOBSITE SUPERVISOR:
Electrical
Framer
Roofing
Mechanical
Concrete
Soler Other Other
Plumbing
Fireplace
Other
Applkartt 1 hereby acknowledge that I have read this application and state that the above Infennadon is ocrrect and agate to con" with all requirements
contained herein and City of Ron jPcOns o Inances and state laws regulating burbling oonstrudlon.
Applicant Signature_ fsRA Print Name .o i f _1 _C cY c�� e. Phone Ciiy - ► 3 �� UT
DiaNbutiort: White -Office Yelknv-Appileant Pink -WWW/Stom ester
IFNI yo, E3IPRES 180 04WY-•9 FPtCvir: AoP;RLi1CATjtt,)h0 D.&TIE