HomeMy WebLinkAbout627 SEDGWICK DR - APPLICATIONS - 8/13/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.conV building
Citv of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 30 -7(9545 / APPLICATION DATE ��� -6) -7
Job Site Address aZ 7 Sect , �C -Dr . Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 3 % 1 - j qo
Last Name U First Name Middle 'DC,&yYI e
Street Address City r StateQ,)_Zip
CONTRACTOR INFO: Company Name
Lic. Holder Nam
Mailing Address_
LEGAL INFO:
Subdivision/PUD
Contractor Phone #
City of Fort Collins License # Supervisor Cart #
State Zip
Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) AW Total Garage Sq Ft
Residential Sq Ft /o/06 Comm'I Sq Ft # of Stories,_ Bldg Height_ # Dwelling Units
1st Floor Sq Ft 0�W 2nd Floor Sq Ft Unfinished Bsmt Sq Ft2" f inished Bsmt Sq Ft - U "rw-
# of Bedrooms 3 # of Full Baths _ 3/4 Baths 1/ Baths # of Fireplaces
Air Conditioning: Ye No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
Water Tap Size Sewer Tap Size 01 Metered. Ye or No Temp. Pedestal:` Yeses or No
Type of Heat: was ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less 1r200 Amp
Value of Construction (including labor, material & profit)
Contact Name & Phone # of JOBSITE SUPERVISOR:
Su contractor Info:
Electrical
Framer
Applicant: I hereby ac
contained herein and C
Applicant Signature
Mechanical
Roofing
Concrete
//�� ❑ Other
41
Plumbing
Other
that I have d t s application and state that the above information is correct and agree to comply with all requirements
Collins or ' ce and state laws regulating building construction.
Print Name 611n v n Phon 7) 9
Distribution: White - Office Yellow -Applicant Pin c - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE