HomeMy WebLinkAbout2919 Skimmerhorn St - Applications/Basement Finish - 05/16/2013COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER ` APPLICATION DATE 5-16 - (3
Job Site Address Z9 I'k 5r.'µA&erkao- ✓ Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Z Z 7zli — G 3 3 (�M
Last nameA, 0-A)0 First Name R& „tJ� e� Middle
Street Address_ _ zi iq 5 K.,t,.Ar -e,rL-o v-AN City IT7 L State C b zip O 1
CONTRACTOR INFO: Company Name
Lic Holder Name
Contractor Phone # 4 7Z - 81 00
City of Fort Collins License # Supervisor Cart #.
Mailing Address -4Z 7y 5. 9,A)e 5 City 47 (! . State G zip
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft 700 Comm'I Sq
1 B1 Floor Sq Ft 2nd Floor Sq Ft _
Finished Bsmt Sq Ft �� # of Bedrooms
Filing # Lot # Block # Lot Sq
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
31 Floor Sq Ft
# of Full Baths 3/4 Baths
Unfiished Bsmt Sq Ft _
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
Value of Construction (including labor, material_t& profit) $ (J. o V
Description of Work: �JCN�e .✓ I 'rr
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 ordjpgflbes and state laws regulating building construction. 7 {� maya,
Applicant Signature Print Name i Sc #1'er Phone .47G - (�
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE