HomeMy WebLinkAbout6118 Constellation Dr - Applications/Basement Finish - 05/19/2011City 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
APPLICATION NUMBER I \Y�( / APPLICATION DATE^
Job Site Address Unit #
PROPERTY OWNER INFO: (Allownerinformation is required — it is not optional) Phone #
Last name First Name Middle ,
Street Address h �� ea �.t S /..e.l ry,•� F . City PC,i, l�i a1; State �o6 Zip �o yT^
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
City of Fort Collins License #.
City,
Supervisor Cert #
State Zip
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft # of Stories Bldg Height # Dwelling Units
15t Floor Sq Ft
2nd Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 1/4 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
Value of Construction (including labor, material & profit) $ !,2,/ 2 ,00
description
Contact Name & Phone #r? of JOBSITE SUPERVISOR:
Aoogubcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
_ Plumbing
Fireplace
Other
Applicant: I hereby ackno edge th I have read this applyion and state that the above information is correct and agree to comply with all requirements
contained herein and Ci of Fort C lins ord iances and laws regulating building construction.
Applicant Signature Print Name Aj <tt�� a (q Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE