HomeMy WebLinkAbout6227 WESTCHASE RD - APPLICATIONS - 9/19/2006BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
Ink www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE ! O
Job Site Address to ,% We5y64S-e- R."A Unit #
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PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # d(o 1
Last Name ��g��Z,� C7 -First Name -Sa►� b �-.�t!j Middle
Street Address 2%-7 0&4-C►2Lsx, 1Z , City_ F6,-I- Co Wn5
State 09 Zip bOS;�
CONTRACTOR INFO: Company Name P06n1mAnr1 Contractor Phone # 19 - 15 30
Lic. Holder Name 4e"rM POeMa✓t/1 City of Fort Collins License " /3 / Supervisor Cert #
Mailing Address 51 -1 syrez City Z-O"f-14nj State CC) zip �OS31
LEGAL INFO:
Subdivision/PUD
Filing # Lot #.
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft 11004 Finished Bsmt Sq Ft �965
# of Full Baths _ % Baths Y2 Baths _ # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing N�
4. E-Star w/Blower Door
5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door 13
/�
List appropriate option #s ' ' J
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: dGas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction ((including labor, material &1p�rofit) $ 1 1 ,
Description of Work: in65 S1'►1411 Par`h�+ � �aSP.r�cGrt�- rn6 Y-e�l"�►ho.+ faGwt . Mo 64raw+5,
Contact Name & Phone # of JOBSITE SUPERVISOR: S)InaWn krr iA
Subcontractor Info: A�,,
Electrical G El e�G Mechanical M, 54M SAn Plumbing
Framer Pc eAh t"411"In k, R fing - Concrete Other
Applicant: I hereb nowledoe a a re this application and state that the above information is correct and agree to comply with all requirements
contained herein an i of s di ce and state laws regulating building con truction.
Applicant Signature Print Name !tid►�-r`- Phone q�tJ-a
Distribution: White — Office Yellow —Applicant Pin — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE