HomeMy WebLinkAbout3538 Long Creek Dr - Applications/Basement Finish - 09/10/2012City of
I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER J APPLICATION DATE / ✓�✓ /�
Job Site Address5 Cis--X Dg, Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name%Y11, r /lam First Name q, �� Middle
Street Address ,, �3�/�/���� City,o-
>-�_u 1— State Zips.
CONTRACTOR INFO: Company NName z L � 0a�4', .� r� (///Contractor Phone #�
Lic Holder Name City of Fort Collins License #,e�Supervisor Cert # G2&7n/ ,
Mailing Address City eKStateno—Zip .C-;q
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft
15' Floor Sq Ft
Comm] Sq
2n1 Floor Sq Ft
Filing # Lot #
Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
V Floor Sq Ft
Unfiished Bsmt Sq Ft 32/?
Finished Bsmt Sq Ft/ci?50 # of Bedrooms A- # of Full Baths J-- % Baths Yz 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. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
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
O
Value of Construction (including labor, material & profit) $
Contact Name & Phone # of JOBSITE SUPERVISOR: C0A) �t�i� %f> - y/;?-
Subcontractor Info:
Electrical aNG/g k-k 1% L�IGMechanical 4/ c` Plumbing
Framer
Solar
Roofing Concrete
Other Other
Fireplace
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 Signa e y � � Print Name Phone 0` m- aa v
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THUS APPLIOATIOM E3LPURES 180 DAYS FROM APPLUOATIOM DATE