HomeMy WebLinkAbout2627 Thoreau Dr - Applications/Basement Finish - 05/29/2007/-49ft
191101
City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
Job Site Address Q/ 017 iAi3A1Qct- 0� Unit # —
PROPERTY O�WNE`R INFO: c'All owner information is required - it is not optional) Phone #� ��� �' S 40 LZ
Last Name KX C- First Name /}
Street Address.% BSI J lit ti1G f� — City( hoc /ii State�Zip �Q -Sq
Middle
CONTRACTOR INFO: Company Name t.Znj�La 42?2w C . Contractor Phone # 69 70J
Lic. Holder Named apu f? /5hzac G� City of Fort Collins License # Supervisor Cert
Mailing Addresszny I�/tu;{�S«� City State_ Zip
LEGALINFO:
Subdivision/PUDV))L^�/'Y 'l( Filing # Lot #_14Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft_11-19- Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
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) $/,�l, /,17
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical-41,1. ,.f l 45tuc Mechanical A 0) Plumbing
Framer Q 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 building construction.
Applicant SignatureJ�PC2ULdiUx Print Namee ,lsf/�Sf2Cl Phone 33n'SyC�
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE