HomeMy WebLinkAbout1819 Overlook Dr - Applications/Basement Finish - 03/03/2010COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
APPLICATION
Job Site Address
281 N College Ave Fort Collins, CO 80522 0580 Phone 970 221 6760
www fcgov corn/budding
UILDING PERMIT APPLICATION
OYcr- 10 o K
APPLICATION DATE 3 —'�' ZV
Unit #
PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone #
Last name be U be r- wnFirst Name haiv L Middle
Street Address
CONTRACTOR INFO Company Name
Lic Holder Name
Mailing Address
LEGAL INFO
Subdivision/PUD
CONSTRUCTION INFO Total Building Sq Ft (not including
City.
Contractor Phone #
City of Fort Collins License #
City State_
Filing # Lot # Block #,
State -zip -
Supervisor Cert #
Zip
Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm I Sq Ft # of Stories Bldg Height # Dwelling Units
1 ' Floor Sq Ft
2 d Floor Sq Ft
3 d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft /4 # of Bedrooms _/_ # of Full Baths '/4 Baths / Y: Baths # of Fireplaces
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
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
J, p L,
Value of Construction (including labor material & profit) $ �d T 8 / /
Description of Work QjC'J►1fw�T f'!rt t i4 Z911PIodn• 4. j �JA_ rochl
Contact Name & Phone # of JOBSITE SUPERVISOR
Subcontractor Info
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
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 C Iins ordinances and state laws regulating building construction Applicant Signature C i`i Print Name (J4M& )4►4e--4 Phone 170
Distribution White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE