HomeMy WebLinkAbout1006 Cuerto Ln - Applications/Basement Finish - 01/07/2014...... City of c COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
�i i Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fegov.com/building
PERMIT APPLICATION
APPLICATION NUMBELk L . 11 U S ,! t✓ `� 5- '� APPLICATION
Job Site Address_ 100Co Cuerfo Lvi jj For-{- & ((w FQS 21 Unit #
PROPERTY OWNER INFO: (All owner information is required- it is not optional) Phone #
Last name A,:FeC1MG1njNt First Name LyS� Middle
treet Address I bO ro ,j a Lt, U t� %+� City_ar'} (o l i hS State t O zip 4 V � 2 i
CONTRACTOR INFO: Company Name
Lie Holder Name
Mailing
LEGAL INFO:
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
City State
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO Total Building Sq Ft (not including basement) I Total Garage Sq Ft
Residential Sq Ft Comm9 Sq Ft # of Stories Bldg Height # Dwelling Units
1� Floor Sq Ft 21 Floor Sq Ft 3" Floor Sq Ft Unfiished Bsmt:S:q3_/-5 Z
Finish Bsm� . t # of Bedrooms % # of Full Baths % Baths / '/, 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 #
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 & profit) $.
Description of Work:_ f &Arvoyh ar�CA Gt Sli PtiAr'aovv. ; t/joer•C 4rr•\c4l aho( -F ,j I'S ned j.t
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Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Mechanical
Roofing
Concrete
Plumbing
Fireplace
Other
Applicant: I hereby acknowiedge 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 SignaturejJXiL�� Print Name ���: n Phone - C
Other
Other
Distribution: White - Office Yellow - Applicant Pink - W W W/Stormwater
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