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HomeMy WebLinkAbout3148 San Luis St - Applications/Basement Finish - 02/09/2009BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 www.fcgov.com/building City of Fort Collins BUILDING PERMIT APPLICATION APPLICATION NUMBER "M DOI 33 APPLICATION DATE Iry 1 Oq Ill Job Site Address Unit # ` PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # Last Name ©yam a-5 First Name `L=t/1 Y► Middle Street Address I So,. City (2o State CO Zip CONTRACTOR INFO: Company Name �'-�hNO`1 Sta�ntractor Phone # q� �� (o o cD Lic. Holder Name.AOS `- VL(qX_ City of Fort Collins License 4-1)2 — 47 Supervisor Cert # �� (o Qi [ /��� j � rr coMailing Address—{ K t �e� l.�—e� `—mil City P+• t ` �S State Zip �A LEGAL INFO: ttAC Subdivision/PUD�0� lCl��, Filing # 3 CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Residential Sq Ft 1st Floor Sq Ft Comm] Sq Ft. 2nd Floor Sq Ft Lot # 2L Block # Lot Sq Ft # of Stories Bldg Height, Total Garage Sq Ft # Dwelling Units Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft (p # of Bedrooms # of Full Baths % Baths '/2 Baths Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing City of Fort Collins Stock Plan # UTILITIES INFO: List appropriate option #s # of Fireplaces 2. ResCheck w/Air Sealing 6. Prescriptive w/Blower Door 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) ption of Work: T C»'t-x 41L� Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: _� Electrical lOi(L2eG— Mechanical �t �—LT Plumbing l e (+lC-k,�' Framer Roofing Concrete 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 SignatureAQ Print Name SCLA Phone ` S - — 3 690 Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE