HomeMy WebLinkAbout2425 Creekwood Dr - Applications/Basement Finish - 08/05/2010COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
City of
F6rt Collins
281 N College Ave • Fort Collins, CO 80522 0580 Phone 970 221 6760
www fcgov corn/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 84oL V (� d / APPLICATION DATE �15-'/0
Job Site Address
Unit #
PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone # (q70 / � 7- UeGL 6
Last name a First Name �✓" io1 Middle
Street Address 0 �7�,� SCiity !%f�l) /S�tateCoZip
CONTRACTOR INFFOj""Coompany Name (, Hb lQfq_l D0( 711 Contractor Phone #Ta7� �1 S z� �Q
Lic Holder Name �lr /G( t/C if t^ 1�%C O ✓i,Dv--
^ City of F✓ ort Collins License # Supervisor Cert ## "
Mailing Address 1 L1y ��GlnA l � L� City �4� State Zip OVo
LEGAL INFO
Subdivision/PU
CONSTRUCTION INFO Total Building Sq Ft (not including
Residential Sq Ft Comm I Sq
1 ' Floor Sq Ft
2nd Floor Sq Ft
Filing # Lot #.
Block # Lot Sq Ft
Total Garage Sq Ft
# of Stones Bldg Height # Dwelling Units
3 d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft Z4ly # of Bedrooms # of Full Baths '/. Baths '/z 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 # List appropriate option #s
UTILITIES INFO
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 8 profit) $ 1 DOW0 :7
Description of Work
Contact Name 8 Phone # of JOBSITE SUPERVISOR
Subcontractor Infjjo��
Electrical In��k_ __ Mechanical �"l� Plumbing 1 �
Framer Roofing Concrete Fireplace
Solar Other r Other Other
Applicant I hereby ackno edgtollms
2ordjkman
his application and state that the above information is correct and agree to comply with all requirements
contained herein and f Fos and state laws regulating building construction
Applicant Signatu Prmt Name;�DAK �n CSOO Phone -
Distribution White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE