HomeMy WebLinkAbout1826 Somerville Dr - Applications/Basement Finish - 06/11/2008BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
,a www.fcgov.com/building
CityofFortCollin I BUILDING PERMIT APPLICATION
APPLICATION NUMBER--,,? APPLICATION DATE
Job Site Address mc �Q%VV'%N- �r It Co` t,u , (Q AOSa( Unit #
PROPERTY OWNER` INFO: (All owner information is required — it is not optional) Phone # a10 -'al0\ - cu I
Last Name First Name_ n ; ('' Middle
Street Address Sant o,s »� City State Zip
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holde ame City of Fort Collins License # Supervisor Cert #
Mailing Addre s City State Zip
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO. Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms # o ull Baths 3/4 Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No En e y info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w ower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
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UTILITIES INFO:
Water Tap Size Sewer Tap Size etered: Yes or No Temp. Pedestal: Yes or No
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Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size `e-sidde_ntiiaall only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
^flue of Construction (including labor, material
Z&rofit)
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical Plumbing
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 City of Fort Collins or^ar}Fes and state laws regulating building construction.
Applicant Signatur Print Name :Q \ L JAP—m Phone- 00 - t'V �A( I
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwat r
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE