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HomeMy WebLinkAbout2839 Canby Way - Applications/Basement Finish - 09/12/2005BUILDING 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 Wi APPLICATION DATE �r /� ✓O,� Job Site Address Unit # G 7 q PROPERTY OWNER INFO: (All owner info tion is quired - it is not optional) r _ Phone ni ,,ne # {-7 © —2, !i 11 p & -/ !' Last Name n Ye*- First Name cS�e, �!!L ---�► Middle Street Address City Pyt W I I InS7 State (.! Zip�M52 CONTRACTOR INFO: Company Name Contractor Phone # Lic. Holder Name City of Fort Collins License # Supervisor Cert # Mailing Ad LEGAL INFO: City. Subdivision/PUD RJ Q aot Farm Filing #. CONSTRUCTION INFQ Total Building Sq Ft (not including basement) _ Residential Sq Ft 1st Floor Sq Ft # of Bedrooms Air Conditioning: Yes No 3. ResCheck w/Blower Door City of Fort Collins Stock Plan # UTILITIES INFO: Lot # State Zip Block # Lot Sq Total Garage Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units 'Vn1d Floor Sq Ft Unfinished Bsmt Sq Ftginished Bsmt Sq Ft 910 # NFull Baths % Baths Y2 Baths # of Fireplaces En gy info: (Circle appropriate choice) 1. ComCheck 4. E-Star lower Door 5. Prescriptive w/Air Sealing Water Tap Size Sewer Tap Size Type of Heat: ❑ Gas ❑ Electric Electric Main B Value of Construction (including labor, material & profit) $ of Work: Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical Mechanical List appropriate option Metered: Yes or No 2. ResCheck w/Air Sealing 6. Prescriptive w/Blower Door Temp. Pedestal: Yes or No Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other Plumbing 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 rt Collins ordi ces and state laws regulating building construction. Applicant Signature Print Name Phone !j 76 '-"�,o,p Z 1 Distribution: hite — Office Yellow — Applicant Pink — WWW Stormwater(O THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE /