HomeMy WebLinkAbout3845 Eclipse Ln - Applications/Basement Finish - 09/02/2010City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOItt Coll s 281 N College Ave Fort Collins, CO 80522 0580 Phone 970 221 6760
www fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE 13/At-)2"
Job Site Address _:�945_ �F /Mm Z-0 Unit # 3'�l /
PROPERTY O"ER INFO
(All owner information is required - it is/n�ottoo tional) Phone #
Last name 7 First Name / - / / k Middle
I Street Address � � r (N City611
/k S State Zip
CONTRACTOR INFO Company Name y Contractor Phone # (/�f /7- Z/ S 2-11 44
Lic Holder Name I/�(J ✓ C, /S�a City of Fort Collins License # Supervisor Cert #
Mailing Address City City StateCe�'_Zip
LEGALINFO
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm I Sq
181 Floor Sq Ft
2 ° Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3r° Floor Sq Ft
Unfiished Bsmt Sq Ft Z
Finished Bsmt Sq Ft �40 # of Bedrooms # of Full Baths % Baths % 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
List appropriate option #s
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 -& profij�$ /i� i �d , 0
Description of Work
Contact Name & Phone # of JOBSITE SUPERVISOR
Subcontractor Info �ii�,, .-j�—, ��"`
Electrical t . 1 Z Mechanical ._ l��C 7 Plumbing / q_
Framer
Roofing
Concrete
Fireplace
Solar Other Other Other
Applicant I hereby acknow)6dgf that ave read tF)is application and state that the above information is correct and agree to comply with all requirements
contained herein and City Fo Colli s ordinances and state laws regulating natur building construction
Applicant Sig ! Print Name ✓�W 57Ly sOLl Phone Z/5
Distribution White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE