HomeMy WebLinkAbout3826 Big Dipper Dr - Applications/Basement Finish - 10/19/2006BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
66 www.fcgov.com/building
CityofFortCollins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 46/ APPLICATION DATE /D ��ie
Job Site Address
PROPERTY OWNER INFO: (All owner information is required — it is not optional)
Unit #
Phone #(g1Q)O?UU -
Last Name First Name L)nil/x III Middle .
Street Address (?�Q IF 3,14 b; Dpr- pr. city Pf cn 110 ✓t S State % _Zip&)'seg!K
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cart #
Mailing Address City
LEGAL INFO:
State Zip
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
`�
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) _)q 1.3 Total Garage Sq Ft I c1 li
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1St Floor Sq Ft I LIc3Lo . lS 2nd Floor Sq Ft 1 �171v _ 1 Unfinished Bsmt Sq Ft 11437, 2 Finished Bsmt Sq Ft 1 70Z
# of Bedrooms 'y # of Full Baths tJ % Baths I % Baths # of Fireplaces
Air Conditioning: lres No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option
6. Prescriptive w/Blower Door
Water Tap Size Sewer Tap Size Metered. Ye or No Temp. Pedestal: Yes or No
Type of Heat: Nr Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less M-200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 3 G%
_
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical aV�pl� l >ti sCMechanical
J
� LL. L
Plumbing 40 V0_t4 ti,,,__ Nu,,,.
Framer 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 Cit %"'&j
Collins ordinances nd tate laws regulating building construction.
Applicant Signature Print Name a '^alC V % A Phone
Distribution: White — Offic Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE