HomeMy WebLinkAbout4307 SHADOWBROOKE CT - APPLICATIONS - 3/26/2012City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
�iBUILDING PERMIT APPLICATION
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APPLICATION NUMBER 1� �' 1 lJ/ ✓ APPLICATION DATE
Job Site Ad
COU
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # q %d— Z 1 '?- V 31
Last name (b,,j rq,,Acon/ r First Name -1CkC%SL01)he2 Middle
Street Address H 3 1 5� G000teA r c0Ok &7 city N . State (0 Zip $ 05;-2
CONTRACTOR INFO: Company Name ICJ A Contractor Phone #
Lic Holder Name A City of Fort Collins License #
Mailing Address City
LEGAL INFO:
Supervisor Cert #
State Zip
Subdivision/PUD W964- bro old Filing # 5T Lot #-Z3-- Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 2 5 Y O Total Garage Sq Ft
Residential Sq Ft Comm] Sq
qZ-2
# of Stories I Bldg Height # Dwelling Units
1s' Floor Sq Ft 25 4 S 2nd Floor Sq Ft 3rd Floor Sq Ft Unfiished Bsmt Sq Ft 1 y® I
Finished Bsmt Sq Ft 35 2. # of Bedrooms L # of Full Baths % Baths '/z Baths # of Fireplaces
Air Conditioning: es No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative S. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option #s
Water Tap Size Sewer Tap Size Metere : Ye or
Type of Heat: QrGas ❑ Electric Electric Main Breaker Size (Residential only)
Value of Construction (including labor, material & profit) $ 2 0e3c'3
Description of Work: F,,QM �l e r i Cd. %._
Contact Name & Phone # of JOBSITE SUPERVISOR:
Electrical
Framer 4 Roofing
Solar Other
Mechanical
Concrete
Other
No Temp. Pedestal Yes or No
❑ 150 Amp or Less M 200 Amp ❑ Other
tit- PPr01
wse 1^onnQ
Plumbing
Fireplace
Other
Applicant: I hergby 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 f Fort Collins ordi nces and state laws regulating building construction.
Applicant Signature / Print Name Cb^f 1�tA- Phoneq-IFr-$3(l
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE