HomeMy WebLinkAbout4213 GOLDENEYE DR - APPLICATIONS - 3/24/2006BUILDING PERMITS & 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 O I 5 APPLICATION DATE 0�
Job Site Address '9Z 1 '3 �ltcr�C yc _ Unit #
PROPERTY DOWNER INFO: (All owner information is required - it is not optional) Phone # nil-10 - ?-Z1 $3 l
Last Name K&tj First Name Middle pN*.,
Street Address 412 13 �ec��+--� Yc- 1�. "� • City R• C o%"-g State C 0 zip $0-1-Z 6
CONTRACTOR INFO: Company Name
Lic. Holder Name
Mailing Add
LEGAL INFO:
Subdivision/PUD
Contractor Phone #
City of Fort Collins License #
City
Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Ot N t
Residential Sq Ft '� % Z Comm'I Sq Ft
1 s' Floor Sq Ft 1 Z 2nd Floor Sq Ft
# of Bedrooms 2- # of Full Baths
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Supervisor Cert #,
State zip
Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
- Unfinished Bsmt Sq Ft� Finished Bsmt Sq Ft 9� 2-
% Baths '/2 Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option
Water Tap Size Sewer Tap Size Metere : Yes r No
Type of Heat: 91Gas ❑ Electric Electric Main Breaker Size (Residential only):
Value of Construction( (-including labor, material & profit) $_
Desc ipti ork: ; t —tZ*V, �A��,n-►c
31 H !� 16 �► IZ cr n �^1
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
Temp. Pedestal: Yes or No
or Less'''is�00 Amp ❑ Other
Contact Name & Phone # of JOBSITE SUPERVISOR: Lrti� �� ��„ �•lcy O - Z21 �� l
Subcontractor Info:
Electrical
Mechanical
Plumbing
Framer Roofing Concrete Other
Applicant: I hereby ackno dge t I h read this application and state that the above information is correct and agree to comply with all requirements
contained herein and Ci f Fo olli rdinances and state laws regulating building construction.
Applicant Signatur Print Name ` Y` �S'-opi����lv�( Phone 'IId- 227 " 7 6
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE