HomeMy WebLinkAbout1208 Catalpa Pl - Applications/Basement Finish - 10/25/2010of
FFCityt` Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER_ -J�) 100 LpfZL+ APPLICATION DATE_ D (%t bW Z5 t Z01 o
-*Job Site Address a O �. r/�o, �j�� ue if Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # J
Last name C ' -in First Name /ZO/j ' 1/� Middle Sha cJ r]
Street Address/� C� C a 4, �/%�� � % City CO�r C o �� . S Statet/(-') Zip
CONTRACTOR INFO: Company Name /70/7C- 06✓'t</r Contractor Phone #
Lic Holder Name
City of Fort Collins License #.
Mailing Address City
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Filing # Lot #_
Supervisor Cert #.
State Zip
Block # Lot Sq Ft
_ Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
15t Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/4 Baths '/2 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
1. Value of Construction (including labor,
material & profit) $
4- Description of Work: ),f sja^�'( ��'�"� O �- � S (O' C �✓ u < �
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 ns ordjnances and state laws regulating building construction.
pplicant Signature /✓�` s� Print Name Y � w\ � ��-� Phone O l�c�� 6l
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE