HomeMy WebLinkAbout2751 Autumn Harvest Way - Applications/Basement Finish - 05/12/2010City of
I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Cotl nS 281 N College Ave Fort Collins CO 80522 0580 Phone 970 221 6760
wwwfcgovcom/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER R / UUa %q 1,�5, APPLICATION DATE y50 M
Job Site AddressZ-751 At Tmw NAtzvrs,- U*i lk CouzHsi CD gosz$ Unit #
PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone # La70, (090-Li4jn
Last name WTxVeiZ First Name i. 94" Middle 1/-AY
Street Address Zl51 Au win%& 4AAZvIESt WAY City HT, Ccx Ls�S State 11O.Zip $OSZ%
CONTRACTOR INFO Company Name kMGM L-EVE-k- CQV4'6TR0tTTCK Contractor Phone #�Io�ZZZ oo9z,
Lic Holder Name!S A vA �`ImAN City of Fort Collins License # Supervisor Cert #
Mailing Address3Xg5 Uo00%AtaoS 1. A,4 City 05%,L c-cTe" State C-D Zip '90E;49
LEGALINFO
Subdivision/PU
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO Total Building Sq Ft ( t I d g b in t) Total Garage Sq Ft
Residential Sq Ft Comm I Sq
Floor Sq Ft
2 Floor Sq Ft
# of Stories
3 d Floor Sq Ft
Bldg Height # Dwelling Units
Unfiished Bsmt Sq Ft IL4L7
Finished Bsmt Sq Ft BIOS # of Bedrooms # of Full Baths / Baths / Baths # of Fireplaces
Air Conditioning Yes No Energy info ( Circle appropr ate 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
List appropriate option
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) $ `i7c& la' i � 1 fjn
Description of Work i=na LSrixN ZI ASE*Aottr �uCLuflZ.AL 1 &-oyao►�. 1 L y mw i tl or. AWo ► t�irr izodN\
Contact Name & Phone # of JOBSITE SUPERVISOR
Subcontractor Info
Electrical %c Mechanical NXRTAi— N\tuwAvM(,S Plumbing Ua r z*A,:giLt�Ant3Zs+Gc
Framer Roofing
Solar Other
Concrete
Other
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 here n and City of Fort Collins ordinances and state laws regulating building construction Applicant Signatu rint Name �HAw�i SrA-t"A Phone(c-QhZZ-009Z
Distribution White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE