HomeMy WebLinkAbout925 SHORE PINE CT - APPLICATIONS - 12/8/2008\ BUILDING PERMITS & INSPECTIONS DIVISION
PO Box 580 • Fort Collins, CO 80522-0580 • Phone 221-6760
www fcgov com/building
CrtyofFortColhns BUILDING PERMIT APPLICATION
APPLICATION NUMBER e ill/ / `��� APPLICATION DATE / U ✓�
Job Site Address '7/t-lvre�I�r,r- jr-/ Unit # PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone #(�97e))\
e=-45Co — -ac�/
Last Name it LLL. First Name l Middle
Street Address GOx- City �! ��:S State-::r Zip 20` a�
CONTRACTOR INFO Company Name
Contractor Phone
Lic Holder Namur l'%o,-S City of Fort Collins License #-bSupervisor Cert #
Mailing Address 3iY 'k- , /0 AA �f City 4g, a State Ca ZIP 20,5 37
LEGAL INFO
Subdivisiorl Filing # Lot # Block # Lot Sq Ft "?-Co
CONSTRUCTION INFO Total Building Sq Ft (not including basement)
Residential Sq Ft
1st Floor Sq Ft
# of Bedrooms
Air Conditioning Yes
3 ResCheck w/Blower Door
Total Garage Sq Ft
_ Comm I Sq Ft # of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
_ # of Full Baths % Baths /L Baths # of Fireplaces
No Energy info (Circle appropriate choice) 1 ComCheck 2 ResCheck w/Air Sealing
City of Fort Collins Stock Plan #
UTILITIES INFO
4 E-Star w/Blower Door
5 Prescriptive w/Air Sealing 6 Prescriptive w/Blower Door
List appropriate option #s
0
Water Tap Size Sewer Tap Size Metered Yes 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) $
Description of Work e r >� /Sh mil/ dr t i�rrr>rnS /a JL�
Contact Name & Phone # of JOBSITE SUPERVISOR C� eT S2! l �ezoj �%1 -Y-4�q
Subcontractor Info /, /J �' ' //
Electrical /�G /I iL9 Mechanical4l, / erh 61 Air Plumbing / U A i! LC iki vgi
Framer _� �,WO,5 Roofing Concrete Other
Applicant I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins ordinances and state laws regulating budding construction
Applicant Signature��i—lam ldp t Name f ,' /<� Phone
Distribution White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE