HomeMy WebLinkAbout1115 Saint Croix Pl - Applications/Basement Finish - 12/09/2010F6rt
Cityof COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER ( 06 T3 / -7 APPLICATION DATE
Job Site Address^ S St, C(O -x Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 970 '- yl? / y� `L-
Last name �/O VC/ First Name De el ►x i S Middle
Street Address
�j / 5� S C r))��® x ill. city �. i �S State C-0 Zip $0 �.2�
CONTRACTOR INFO: Company Name /`BPS il�; rc- I B(A i f de r3 Contractor Phone # 70',2,2 y` 5-z;-2 -7
Lic Holder Name Do^ S Ott City of Fort Collins
rLicense # 'w � Supervisor Cert # 2066 -02
Mailing Address 2.30 i M o ►z� r c�a• I c �'� _ City �K . C-o State �y Zip
LEGAL INFO:
Subdivision/PUD Star ter. acee. k Filing #_ ;21 Lot #_g_y_ Block # 2- Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement
Residential Sq Ft Comm'I Sq
15' Floor Sq Ft
2nd Floor Sq Ft
# of Stories Bldg Height.
3'd Floor Sq Ft
Total Garage Sq Ft
# Dwelling Units
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft 375' # of Bedrooms # of Full Baths % 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
Value of Construction (including labor, material & profit) $ -1p
3 9.5,
ptionofWork: GcOiC Mcv�� i';r�:S� pt�t bit royr� �'t f�ow� feC�i rc7opsn.
_ r
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical korne
Framer
Solar
Roofing
Other
Mechanical Ai't Plumbing bjefv-orc R"ti"elti
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 herein and C of ort Collins dinances and state laws regulating building construction.
+
Applicant Signature Print Name )]ci J (10 t •k- Phone 2 y '"Sb; 7
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE