HomeMy WebLinkAbout4913 SMALLWOOD CT - APPLICATIONS - 6/15/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.conVbuilding
CityCityofF BUILDING PERMIT APPLICATION
APPLICATION NUMBER (J n �V / APPLICATION DATE
Job Site Address '411.3 Sr,Atcw
U . der C U,, 5i 60 S05z6..... _ _.Unfit #
PROPERTY OWNER INFO: (All owner information is required -
it is not optional) Phone # `970i
01- 9-6 1 Z
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Last Name
First Name
IOOU/ Middle
Street Address �.5rAA-,(,wo6ct
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CityI 04 �wS State p �i
CONTRACTOR INFO: Company Name
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' ` Contractor Phone #- QR70-)
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Lic. Holder Name
City of Fort Collins License #
Supervisor Cent #
Mailing Address 4113 5-Qwo4,S
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City Fo2a- ,CptLt .5 .
State CG Zip gas 2 8
LEGALINFO:
Subdivision/PUD / Filing # Lot #�� Block # Lot Sq
Residential Sq Ft
1-t Floor Sq Ft
# of Bedrooms
Total Building Sq Ft (not including basement)
Comm'I Sq
2nd Floor Sq Ft
# of Full Baths
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
% Baths V2 Baths # of Fireplaces
Air Conditioning: Yes 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 # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas RElectric Electric ISlam Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp B10ther
Value of Construction (including labor, material & profit) $ 000'r'c>
l/ a^fi; / _ ..
Description of Work; ( Mom./ . �f�f,¢� o�
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Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: ® V / 1 1 "5 ® 7
Electrical ( - `'_Qkhanical M�
Framer
Roofing
Concrete
Plumbing
Applicant: I hereby ac w ge that hayyf: read t applicatigp+and staterthattlag!apove information is correct and agree to comply with all requirements
contained herein and Ci of on Collins chance ai d state laws regulating building construction. D
Applicant Signature_ Print Name �r�d AUVOI Phone6%-70) 63/-S10
Disttlatrton: Whie-Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE ��