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HomeMy WebLinkAbout6215 WESTCHASE RD - APPLICATIONS - 4/1/2005BUILDING PERMITS & INSPECTIONS DIVISION " * P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 www.fcgov.com/building CityofFort Collins BUILDING PERMIT APPLICATION APPLICATION NUMBER APPLICATION DATE Job Site Address _�'/) J f d�rl % C/,��G'� Unit # PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # Last Name / First Name Middle Middle Street Address �r ,7 / ����/ ��fi�d G ' CityC� State Zip CONTRACTOR INFO: Company Name Z2 T,L Contractor Phone # �>,7U — 4 11 Y-Z 71 Lic. Holder Name- OUP ��� City of Fort Collins License # Supervisor Cert # Mailing Address,/% f G��`/fJ.L�G'%r�G� ©/� City State Zip LEGAL INFO: Subdivision/PUD ` �� Filing Lot #_ Block #,f7 Lot Sq Ft, CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Residential Sq Ft Comm] Sq 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 # of Full Baths Total Garage Sq Ft # of Stories Bldg Height # Dwelling Units Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft,�l— 3/4 Baths _ Z '/z Baths # of Fireplaces Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door List appropriate option #s 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: Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical T e Framer Roofing Mechanical Concrete Plumbing Other Applicant: I hereby ackn a that I have read this application and state that the above information is correct and agree to comply with all requirements contained herein and y of Fo ollins ordinanc and state laws regulating building construction. (� (4Applicant Signatu FYI Print Name _ ��� Phone L71 Dis ution: White — Office Yellow —Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE