HomeMy WebLinkAbout1518 Freedom Ln - Applications/Basement Finish - 02/18/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
PPLICATION NUMBER6 APPLICATION DATE CJ ✓� /�
\ ob Site Address f;(,t E. a wN'1 l_.(LnL V-C �'()-;Zl'unit #
(&OPERTY OWNER INFO: (All owner information is required —it is not optional) Phone #
Last name �C�Y iiC�+.9� First Name / Middle �
( 1�6 Cvi cam(, �
Street Address 7; ��� C/� �1��r� � City }� 1 if/ State �. 7 : Zip �(i%
CONTRACTOR INFO: Company Name .ScA [' Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address.
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm] Sq
15f Floor Sq Ft
2nd Floor Sq Ft
City State Zip
Filing #
ement)
# of Stories
Lot #
31d Floor Sq Ft
Bldg Height.
Block # Lot Sq Ft
Total Garage Sq Ft
# Dwelling Units
Unfiished Bsmt Sq Ft
Ytinished Bsmt Sq Ft San # of Bedrooms I # of Full Baths 1 3/4 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:
Water Tap Size Sewer Tap Size
List appropriate option #s
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, alue of Construction (including labor, material & profit) $
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 Collins ordinances and state laws regulating building construction. c j
pplicant Signature Print Name L:�.f� Ba� t/1�=�l t Phone 22
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE