HomeMy WebLinkAbout1830 Indian Hills Cir - Applications/Basement Finish - 10/05/2012City of
Frt Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER V APPLICATION DATE l D1�" l�
Job Site Address/
3 L3 I NDIAKI W LLS C) F, . #
PROPERTY OWNER INFO:
(Unit
(All owner information is required - it is not optional) Phone # (- �J - oul
Last name LgYE
First Name U0 6Middle
Street Address /9 5 n
l %J Ji l A bi �I l l j 5 0 Rity f / (�40 L- % )P-S state c o Zi.00 52
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
City of Fort Collins License # Supervisor Cent #
Mailing Address
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
181 Floor Sq Ft
2nd Floor Sq Ft 31d Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/, Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No
Energy into:( 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
# 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) $ a?I/i-7��/D
Description of Work: S ccsc+m
m �f & n 6 17 -a a'T 1 De4i
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical / I G � LL
6
Mechanical ?/c t 1`XJ Plumbing m C 6) �L
Framer
Roofing Concrete Fireplace
Solar
Cher Other Other
Applicant: I hereby cknowle gejClins
av read this application and state that the above information is correct and agree to comply W11.75quirements
contained herein an City of F rt ord ancesand state laws regulating building construction.
C I // (lJl
Applicant Signature 1A A A Print Name �YV l� C Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE