HomeMy WebLinkAbout4436 GOSHAWK DR - APPLICATIONS - 3/2/2007BUILDING PERMITS & INSPECTIONS DIVISION
(id � 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 Ad `(J /0-3 APPLICATION DATE ��✓
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PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # (9
Last Name LGhSoYI First Name E(I K� I Y.)i Y1d Middle
Street Address fits �-QL*—Dr. City (6I 1Ii1S
CONTRACTOR INFO: Company Name
Lic. Holder Name
Mailing Address
LEGAL INFO:
Residential Sq Ft
1st Floor Sq Ft _
# of Bedrooms
Contractor Phone #
City of Fort Collins License #.
City
Filing # Lot #
Total Building Sq Ft (not including basement)
Comm'I Sq
# of Full
Sq Ft
Air Conditioning: Yes No Energy
3. ResCheck w/Blower Door 4. E-StasA
City of Fort Collins Stock Plan #
UTILITIES INFO:
Supervisor C
State Zip
Block # Lot Si
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
_ Un ' shed Bsmt Sq Ft Finished Bsmt Sq Ft _
_ 3/4 Baths '/z Baths # of Fireplaces
opriare choice) 1. ComCheck 2. ResCheck w/Air Sealing
Door 5. Pr tive w/Air Sealing 6. Prescriptive w/Blower Door Q
List appropriate option
Water Tap Size �� Sewer Tap Size Metered: Yes or No Temp. Pe- 2stal. Yes or No
Type of He5p,' ❑ Gas ❑ Electric Electric Main Breaker Size (Residential
only): ❑ 150 Amp or Less ❑ 20D4mp ❑ Other
Value of Construction (including labor, material & profit) $y v
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR: , � n� b[)Tl ')�-UJLDk-k-
Subcontractor Info:
Electrical
Mechanical
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 IBC YIs� ,IG�g2'ncn Print Name 6 "1r :BL&G -I Phone
u� Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE