HomeMy WebLinkAbout2851 Canby Way - Applications/Basement Finish - 04/09/2014COMMUNITY DEVELOPMENT 8 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 IA DI �� APPLICATION DATE
Job Site Address Z TrS'I Doll% ,h M WAM Unit #
J 1 /�/�
PROPERTY OWNER INFO: (All owner information is required - it Is not optional) Phone # 9 -t0 'a aI g� i1 "jj:
Last name-0 /.tt b 4/ l First Name /� IrG Middle ;1 tir
Street Address 2��� W4,1.0 City F'�VKi CO /j; J1.5 State Cy Zip -S
CONTRACTOR INFO: Company Name
l� � N Y S . Contractor Phone # :2Z 7 ^ ? CS0
Lic Holder Name to lr )'``, City of Fort Collins License # Supervisor Cart #
Mailing Address % Z. Y SOGLy r v4, Ghy `^ fJ } • City- �t�fyY� State Zip / S�
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
1s' Floor Sq Ft
2nd Floor Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
31d Floor Sq Ft
Unfiished Bsmt Sq Ft 1382.
Finished Bsmt Sq Ft 3G # of Bedrooms -4(— # of Full Baths % Baths '/z Baths # of Fireplaces
Air Conditioning\ es)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
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) $ !r,fy /
Description of Work: f hArw1( � *-A he 4 ruo'M't � 01-e� � as A vii a _ j n s a I4 sY �
A t - - t /�j - A - Al
Contact Name & Phone # of JOBSITE SUPERVISOR: S �Q�4 r trYA-- ZZ -7 ^ %.5,y
Subcontractor Info: ,O /
Electrical t4i zk O11L�-t Mechanical C-I f � IA �` A % Plumbing o 41 et 6-.4- p 7
Framer //fit --Wt Roofing Concrete Fireplace
Solar Other Other Other
Applicant: I hereby acknowI dg 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 Fo Collins ordinances and state laws regulating building construction.
Applicant Signature Print Name -7Phone Z.2-77^71r»
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE