HomeMy WebLinkAbout925 SHORE PINE CT - APPLICATIONS - 4/11/20085�,
/ BUILDING PERMITS & INSPECTIONS DIVISION
EO. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER YJy 90'� 2 5�APPLICATION DATE // V
Job Site Address gas' 5� We Z� l Unit #
PROPERTY OWNER INFO: (AII owner information is required - it is not optional) Phone # %70• Zu[ • 07g`
Last Name �'.Q/ST First Name �i�%.ell tc Middle
Street AddressCity Z!�7r/ StateZ:2? Zip
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGALINFO,
Subdivision/PUD IGL�Gr d�it— ✓� Filing # Lot # Block # •� Lot Sq Ft..
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) a Total Garage Sq Ft yG 62
Residential Sq Ft _-22-Zf Comm'I Sq Ft # of Stories f Bldg Height # Dwelling Units /
1st Floor Sq Ft 22 2 y 2^a Floor Sq Ft Unfinished Bsmt Sq Ft yGQ Finished Bsmt Sq Ft f
# of Bedrooms 3 # of Full Baths o? % Baths Y2 Baths # of Fireplaces
Air Conditioning: 457 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
Water Tap Size Sewer Tap Size Meterst5 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) $ /lJ, e r
Description of Work: 6✓%z/lG ,�G-'4C_
fir//IzD�OlrJ ,
Contact Name & Phone # of JOBSITE SUPERVISOR:O-7
Subcontractor Info: 3/O, sz,1,v die/-7Uir✓
Electrical jGr Al - Mechanical Plumbing e Cee 2
Framer Roofing Concrete Other Z,:222X2 A;/tr
Applicant: I hereby acknowledge that I have read this applicatlgn and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins ordinances and st laws regulating building construction.
Applicant Signatur Print Name /"Phone
Di ribution: ite - Office Yellow -Applicant Pink - yW WWStomrwater
THIS PP ON EXPIRES 90 DAYS FROM APPLICATION DATE