HomeMy WebLinkAbout807 Columbia Rd - Applications/Basement Finish - 05/08/2013City
}of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
�` Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 3 30a n I APPLICATION DATE <S 3 - `✓
Job Site Address SO-1 Coltimbta RA. ��. 4�0��twS, CO Unit#
PROPERTY OWNER INFO: (All owner information is required - it Is not optional) Phone # q -7 b • '2_1 9 -y'Koo
Last name SCA u ma 6he y- First Name \A s0 >^ Middle rtrp u k
Street AddressQP-1 C_,-,It kyn b 1 ot ROgj City I- • Ca 1 I tnn State C-o zip
CONTRACTOR INFO: Company Name Contractor Phone
Lic Holder Name City of Fort Collins License # Supervisor Cent #.
Mailing Address City
LEGAL INFO:
Subdivision/PUD�o Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including
State
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories_ Bldg Height # Dwelling Units
15' Floor Sq Ft L4/0-0 2nd Floor Sq Ft 3'd Floor Sq Ft Unftished Bsmt Sq Ft
y�o
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths _ '/4 Baths 1 /z Baths # of Fireplaces
Air Conditioning: es 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,3izte (J�e idential only) 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $f / �•7 ia
n/
Description of Work: &ATIA- 1 &r1'gt1VZ_ Ftw4 l f /Y/?r2 T#,e 1iK%
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical FzSS Cf 1: Mechanical Plumbing _;P%lar P/ttijk,
Framer ?6f Sn' Roofing Concrete Fireplace
Solar
Other
Other
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 Signature Print Name sal 1 5jW%%ACfwPhone Ly 0 J
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE