HomeMy WebLinkAbout4705 Venturi Ln - Applications/Basement Finish - 03/09/2012City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort+t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ � wwwJcgov.comibuilding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 2)1 ec u �� APPLICATION DATE
Job Site Address 476 6 V6yTuk I LAII E Unit #,
PROPERTY OWNER INFO: (All owner information is required- it is not optional) Phone # R -10 `ZZ,S 'O q3)
Last name teQ 1L .1�T First Name }�H�'02i M c'- Middle
Street Address Li4t�-ji� City�QFE:% C.t7GL//u& StateZip 05
CONTRACTOR INFO: Company Name
Lic Holder Name
Contractor Phone
City of Fort Collins License # Supervisor Cert #_
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD FMP—LOAV Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
1s' Floor Sq Ft
2nd Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft 12� # of Bedrooms # of Full Baths '/. 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: 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) $ /a 0 0 0
Contact Name & Phone # of JOBSITE SUPERVISOR: 4�A fto=alLp�rgvr - Q V-31
Subcontractor Info:
Electrical E I Ma l zlec'f r'/ L
Framer �fl / l x0r) et Roofing_
Solar
Other
Mechanical
Concrete
Other
Plumbing ;'yQ171>°S l OeY
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�
Applicant Signature Print Name iqT !!tJ& [WOLt' Phone [ 7D' Z25" Oi�W
Distribution: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE