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HomeMy WebLinkAbout2862 Kansas Dr - Applications/Basement Finish - 12/28/2009BUILDING PERMITS &i 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 !i�D U I YIP APPLICATION DATE I a !';� a I© I Job Site Address al� 'Dr t+ Unit # G��j PROPERTY OWNER INFO: (All owner information is required - it isnotoptional) Phone # 3Vy ✓ l 1 1 ��' Last Name V�d'`�SVv� First Name LIU* Middle Street Address 2—%62 .,�/ 5ct Dr Ug11y` City 54 (.8,1.�j State--C—OZip&Kz� CONTRACTOR INFO: Company Name Lic. Holder Name Contractor Phone # City of Fort Collins License # Mailing Address City LEGAL INFO: Supervisor Cert #. State Zip Subdivision/PUD Filing # Lot # Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not including basement) I <, v(-) Total Garage Sq Ft Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units / " 1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft `' `� d 3/4 '/z �_ # of Bedrooms _3 # of Full Baths Baths Baths # of Fireplaces Air Conditioning: Ye No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door City of Fort Collins Stock Plan # UTILITIES INFO: Water Tap Size Sewer Tap Size List appropriate option #s 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 (V Value of Construction ((including labor, material & profit) $ ` t f ©` - C)y Description of Work: rt n�Shi v..q_ �► +D -o-pm ,."rooe-, a- A viDrAci•L Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Payl-sSun Electrical jl °�r'�— Mechanical OW904-Plumbing I V IUf t�i.h 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 Signature Print Name TC`�� LC��i1Y\ Phone Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE