HomeMy WebLinkAbout214 E Elizabeth St - Applications/Basement Finish - 03/08/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rt Collins 281 N. College Ave. - Fort Collins, CO 80522-0580 • Phone: 970-221-6760
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www.fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
*b Site Address Z 14 `-6 -a w Unit #
CROPERTY/OWNER INFO: (All owner information is required- it is not optional) Phone #
Last name L- o r { Ni' s E First Name +� Middle j ( r
Street Address Z 14 1E® El 7 `i"-r-& -5+ c-a 16-A State ( Zip ( i 71 9
+KCONTRACTOR INFO: Company Name :S4 d-' Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building t (not including ba
Residential Sq Ft Comm'I Sq Ft
City State Zip
Filing # Lot # Block # Lot Sq Ft
1st Floor Sq Ft 2nd Floor Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of
Air Conditioning: Yes No Energy info: ( Circle appropriate oice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative . Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
lent) Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units _
3'd Floor Sq Ft Unfiished Bsmt Sq Ft _
Baths 3/4 Baths '/z Baths # of Fireplaces
List appropriate
#s
Water Tap Size Sewer Tap Size Metered: Yes or No emp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or ss . ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 36 4Y
KDescription of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical
Framer Roofing
Solar Other
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. p
pplicant Signature 4,, ";:OA4 Print Name C' f.9¢" Phoneq
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE