HomeMy WebLinkAbout640 Monte Vista Ave - Applications/Basement Finish - 03/12/2014City of
II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
wvvw.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBEm li Id rl 11 !! 9 f ~i APPLICATION DATE �I AFL • I M - ZD) 4
Job Site Address Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # .3 L! l 6
Last name iFirst Name _' Y Middle
6,Street Address yo 4d a til k /JS h City r7 C State Cy Zip _
CONTRACTOR INFO: Company Name B g r= k upV 0 Q Contractor Phone # c3cC I 5 3 Z V
Lic Holder Name ) n N ro YO 0 60 K,/ City of Fort Collins License # Supervisor Cart #
Mailing Address
5 Z S D✓vd 1Y city
7C- State 0,'5 Zip �a v
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
Is' Floor Sq Ft
31 Floor Sq Ft Unfiished Bsmt Sq Ft S
Finished Bsmt Sq Ft �(445F. # of Bedrooms # of Full Baths '/, Baths _L_ '/I Baths n # of Fireplaces 0—
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:
2nd Floor Sq Ft
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: ,0 teK ✓'tY� G l�•aS �� �w`�"�`-
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby apkl owledge!APPLICATION
read this a�, lication and state that the above information is correct and agree to comply with all requirements
contained herein a City of Fort inanc rf tate laws regulating building construction.
Applicant Signatu Print Name Eo "W ,�fit.SVPi Phone, r S3 Z` l
bution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THEXPIRES 180 DAYS FROM APPLICATION DATE