HomeMy WebLinkAbout749 Bentley Pl - Applications/Basement Finish - 09/24/2010City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. a Fort Collins, CO 80524 a Phone: 970-416-2740
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER —5 110 ® (9 o 9 b APPLICATION DATE ! ` 0
Job Site Address 749 Bentley Place Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # (970) 689-3356
Last name Henckel First Name Randy Middle S.
Street Address 749 Bentley city Fort Collins State CO Zip 80526
CONTRACTOR INFO: Company Name NSA
Lic Holder Name
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
Mailing Address City
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Filing #
State Zip,
Lot # Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comml Sq Ft # of Stories Bldg Height # Dwelling Units
ls' Floor Sq Ft yo 21d Floor Sq Ft 31d Floor Sq Ft Unfiished Bsmt Sq Ft 152-
Finished Bsmt Sq Ft I±2 # of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces
Air Conditioning: YerNon Energy info: ( Circle appropriate choice ) 1. ComCheck11 2. ResCheck w/Air Sealing 11
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 #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes F—]NoF-1 Temp. Pedestal Yes❑ No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) Ill50 Amp or Less 200 Amp Other
Value of Construction (including labor, material & profit) $ 12,000 31, 2
Description of Work:
Finish Basement ) 31.1 &v1-HRw . l 060ROoMl, PLA4 W006Odf f?C10M, FAALN &QJM , 6-R9/L449 &23M
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
Fireplace
Solar Other Other Other
Applicant: I hereby acknowl d e that I e read this ap tion and state that the above information is correct and agree to comply with all requirements
contained herein and City of rt Colli ordinances an sta laws regulating building construction. 1, 1
Applicant Signature Print Name /CA 41 P64a,(-. Phone �/ (0 89'3.66
Distribution: White - Office Yellow - Applicant Pink - VWVW/Stormwater