HomeMy WebLinkAbout2713 Antelope Rd - Applications/Basement Finish - 02/24/2012BUILDING PERMITS &INSPECTIONS DIVISION
P.O. Box 580 •Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER I DD l�y APPLICATION DATE C3)c�--
Job Site Address 27/3 eup
PROPERTY OWNER INFO: (All owner information is required -it is not optional) Phone #.
Last Name _/w/AMZ;Ae:i jMAj First NameZj}M1a4igz Middle
Street Address 45?'7/9 City Ap1117tlS State+. zip 8b6-ems
464�r Ice
CONTRACTOR INFO/:; Company Name e fit+irtF cun' Contractor Phone #
Lic. Holder Name City of Fort Collins License Supervisor Cent #
Mailing Address 46qv:�City- State 4!:?,-. zip Qb'�5 a
LEGAL INFO:
Subdivision/PUD
Filing # Lot #.
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq
1st Floor Sq Ft
# of Bedrooms
2nd Floor Sq Ft
Unit #
Block # Lot Sq
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft t! 70
# of Full Baths % Baths Y: 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. E-Star w/Blower Door 5. 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 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) $ Q D t 3l]
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical 91riE�L • t_e, �+ dnz.c'N1t?chanical !I 1' 0d,c�3 PlumbingWLr� �P4.0A
Framer
Roofing
Concrete
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 din nces and state laws regulating building construction.
Applicant Signature Print Name 4aE4g rr Phone q'7U -.5 7
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE