HomeMy WebLinkAbout2815 Rigden Pkwy - Applications/Basement Finish - 10/31/2012City of
Fort 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,��i -- APPLICATION DATE 'I
Job Site Address �S(/S 1L ��I.� PK�ilo Unit # Q
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Z VO 97( /
Last name �yiNoi�_bf First Name Middle 14/
Street Address his/S �r�� ^^� City R?e-�� f^ State Co zip
CONTRACTOR INFO: Company Name
Lie Holder Name
Mailing Address
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
ls' Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: 6P No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2n° Floor Sq Ft
Contractor Phone #
City of Fort Collins License #_
Filing # Lot #
Supervisor Cert #
State
Block # Lot Sq Ft
_ Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
V Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/4 Baths '/2 Baths # of Fireplaces
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: 2rGas ❑ Electric Electric Main Breaker Size (Residential only) -N 150 Amp or Less ❑ 200 Amp []Other
Value of Construction (including labor, material & profit)
Description of Work: &t5w A-r F n 1 t h
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
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 rdinance and state laws regulating building construction.
Applicant Signature Print Name Ijk4i-y Phone 97y 371 :F76
Distribution: White — Office Yellow— Applicant Pink — WWW/Stormwater
THIS APPLOCATION lE3LPORES 180 DAYS FROM APPLUCATOON DATE