HomeMy WebLinkAbout3551 GREEN SPRING DR - APPLICATIONS - 7/6/2006BUILDING PERMITS & INSPECTIONS DIVISION
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P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.conVbuilding
Citv of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1/� O� ` APPLICATION DATE
Job Site Address Unit # ('p
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # �,% D
Last Name I A 1, Q L 17 First Name Brad Middle
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Street Address �5 �1 City 7T�rl i State �Zip G Sa
CONTRACTOR INFO: Company X111-ile
YY1� !'L�1 . Contractor Phone #_ _ [ 0 - �r70 -/ ! -3v
Lic. Holder Name r7aK m City of Fort Collins License # t�l -% 3 1 Supervisor Cert # �J
Mailing Address / / 1V (� i � - City �State CC) Zip WS 00
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmm^t Sq Ft �G Finished Bsmt Sq Ft I 0 SC)
# of Bedrooms.. # of Full Baths 3/4 Baths ', '/z 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: DIIGas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
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Description of Work: � �S4=t'"►�� �i � � �L, � i n�� �Pi �i J ih�i
Q2Set C 52 a c'er,
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: /�
Electrical 11 l%" � Alechanical &O SUDS 4Ln 11 t Plumbing CCi o % &,i,
Framer Roofing A ! Concrete /V Other
Applicant: I hereby acknowledge that I hav read this application and state that the above information is correct and agree to comply with all requirements
contained herein anQ sty of Fort Co;' inbqces and state laws regulating building construction.„ /
Applicant Signature-- � ), Print Name- -aV A-, 'L- - Phoner'I76 A )i4g3 `)
Distribution: White — Office Yellow — Applicant ' Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE