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HomeMy WebLinkAbout2933 Des Moines Dr - Applications/Basement Finish - 01/06/2012City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES FOI t Collins 281 N. College Ave. a Fort Collins, CO 80524 • Phone: 970-416-2740 /� www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER / �7 APPLICATION DATE /—/4�Ira_ Job Site Address M33 D£SM6t n Du Unit # PROPERTY OWNER INFO: (All owner information Is required - It is not optional) Phone # ! / V - ;�3 I - 7097 Last name KOSFiy First Name /Qi4ur Middle Street Address ay 33 Di's il')OS'H E! Piz City Farr cel aw State <Q Zip�5-25' CONTRACTOR INFO: Company Name rTFVF yfNc,-y Contractor Phone # %%o " S 3 q_ 0(5p Lic Holder Name 5Tr-c— / E 94F"a f= y City of Fort Collins License # Supervisor Cart # Mailing Address / ? 091 N:3 Rfi1 D l!'*(ki E City Qlrge C% State C 0 Zip Pd 6 39% LEGAL INFO: p , n Subdivision/PUD / % 77 n 6W Filing #, S Lot # oC Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not Including basement) Total Garage Sq Ft _ Residential Sq Ft 2 c/ r/ Comm-1 Sq Ft_0 # of Stories Bldg Height # Dwelling Units 1 ° Floor Sq Ft �(7 2^ Floor Sq Ft 31 Floor Sq Ft Unfiished Bsmt Sq Ft 11&6 Finished Bsmt Sq Ft 96)/ # of Bedrooms # of Full Baths % Baths Y2 Baths # of Fireplaces Air Conditioning. Ye�]No Energy info: ( Circle appropriate choice) 1. ComCheck ❑ 2. ResChedk w/Air Sealing 11 3. ResCheck w/Blower Door Iq 4. Simulated Performance Altemative❑ 6. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door City of Fort Collins Stock Plan # List appropriate option #s UTILITIES INFO: Water Tap Size Sewer Tap Size Metered: Yes alloo Temp. Pedestal Yes❑ No Fd Type of Heat: © GasElectric Electric Main Breaker Size (Residential only) 0150 Amp or Less ❑ 200 Amp DOther Value of Construction (including labor, material & profit) $ Description of Work: F1_M1YN RfL Pbv11 t.1/ 43;Ukporr�_ , 13o9lV Eo/ I . AAW !AA/lc`*s1-iF0 9Q <. Acc n/Q/ZY t�Eol�—ul�r Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: // �^ /� n-- Electrical _OMA 0/lr S L 6, 'MI-C Mechanical 1 /�f 1164 X6 { 111:4 Plumbing P,17TiYL Framer Solar Roofing Other Concrete Other Fireplace Other Applicant: I hereby acknowledge that 1 have read this application and state that the above information is correct and agree to comply with all requirements contained herein and City o ollins ordinanccess and state laws regulating building construction. Applicant Signature �< Y " L�� PrintName r7f0f- HE916� Phone 970-579 -0/57g� Distribution: White -Office Yellow - Applicant Pink -VWWV/Stonnwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE