HomeMy WebLinkAbout5409 Golden Harvest Way - Applications/Basement Finish - 05/30/2012BUILDING PERMITS BL INSPECTIONS DIVISION
P.O. Box 580 •Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER' 4::; APPLICATION DATE_y�]
Job Site Address 7iY01 Golapn Hay`rps lr ( Cksj Unit #
PROPERTY OWNER INFO: (All owner Qin.f�o�rjn�ation is req ,red —1'71r
of ti_ opal) Phone # `C /�— `y
Last Name p�� t�S'Ft7d0►'' Firs Name^ `1-Q�1 _ Middle
Street Address Pd 8& 21-30091 City fF ( �1 v�S State On zip`` U w
CONTRACTOR INFO: Company Name .� r.456, J,� ,Contractor Phone # �7o -!5
Lic. Holder Name�°Cyt.t 11 er, City of Fort Collins License #_1) 3 Z.-,R_ Supervisor Cert #
Mailing Address loaa�l �� City ���'�t tnS Staten zip
LEGALINFO: ,,ll
Subdivision/PUDFiling # Lot #.
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft 9— Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st 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 ZS
# of Full Baths 3/< 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
Water Tap Size Sewer Tap Size
List appropriate option
Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)
Contact Name & Phone # of JOBSITE SUPERVISOR: cJ , FI I Frn " 1 /O
Subcontractor Info:
Electrical
Framer Roofing
Mechanical
Concrete
Plumbing
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 1►`q Print Name _ k Phone"f Z) %S ?"»S
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE