HomeMy WebLinkAbout4342 WESTBROOKE CT - APPLICATIONS - 9/10/2010Fotrt Collins
of
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N College Ave Fort Collins CO 80524 Phone 970-416 2740 &✓I L13
www fogov eortt/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER t QQ 5 Ill APPLICATION DATE � O
Job Site Address 4342 Westbrooke Ct Unit #
PROPERTY OWNER INFO. (All owner Information Is required - it is not optional) Phone # 970 377 2427
Last name Jensen First Name Brad Middle Michael
Street Address 4342 Westbrooke Ct C,tvFort Collins state Co Zip 80526
CONTRACTOR INFO Company Name (homeowner) Contractor Phone #
Lic Holder Name
City of Fort Goldin License # Supervisor Cart #
Mailing Address City State Zip
Subdivision/PUD Filing# Lot# Block# Lot So Ft
CONSTRUCTION INFO. Total Building Sq Ft (rot ndud no be ement) 240 a4 ft Total Garage Sq Ft
Residential Sq Ft 240 Sq ft Comm I Sq Ft n/a # of Stories 1 Bldg Height 1 Oft # Dwelling Units n/a
1 Floor Sq Ft 240 Sq it 2nd Floor Sq Ft n/a 3rd Floor Sq Ft n/a Unfiished Bsmt Sq Ft n/a
Finished Bsmt Sq Ft n/a # of Bedrooms n/a # of Full Baths 1,1/8 V Baths n/a % Baths n/a # of Fireplaces n/a
Ali Condltloning• Yea Energly lnfb (Cbclo appropnate choice) 1 ComChsck ❑ 2 ResCheck w/Air Sealing ❑
S ResCheck w/Blower Door 4 Simulated Performance Alternative❑ 5 Prescnptive w/Air Seabng[] 6 Prescnpt ve w/ Blower Door
City of Fort Collins Stock Plan # List appropnate option
UTILITIES INFO,
Water Tap Size Sewer Tap Size Metered Yes [:]No[:] Temp Pedestal Yes[:] No ❑
Type of Heat 0 Gas ❑Electric Electric Main Breaker Size (Residential only) ❑150 Amp or Less ❑ 200 Amp DOther
Value of Construction (including labor material & profit) $ -Sri 1 Osii 01(j co
Description of Work.
Single level 240 so ft addition on the east side of house
Contact Name & Phone # of JOB8ITE SUPERVISOR Brad Jensen 970.222 7510
Iluboontracl or Infb.
Electrical Mechanical Plumbing
Framer Roofing Concrete Fireplace
Solar Other Other Other
Applicant. I hereby a ad tliis application and state that the strove information is coned and agree to comply with all requirements
contained herein and ty of rt I o s and state laws regulating budding construction
Applicant Signature Onnt Name Brad M Jensen Phone 970 222 7510
Distribution White -Office Yellow -Applicant Pmk-VWVW/Stomwvater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE