HomeMy WebLinkAbout2709 Rock Creek Dr - Applications/Basement Finish - 04/11/2012City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
�t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER F/ 1 7 r 1 1 \ . APPLICATION DATE
Job Site Address "Z--7 D 1 /Zie-k Cree k- Tyr. '"TC, 349 7� Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # g 70 - 6 72 - Z 6 S
Last name LS fi 73 r; t = First Name GL I r✓ r0 ✓LQ Middle S M t T rf
Street Address 2% 01 /2. c 1"- Gru k- (.1--_ City FoiJr Co items State CD Zip O � I '7
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
Contractor Phone
City of Fort Collins License # Supervisor Cert #.
City 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'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
3r° Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/< Baths '/z 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:
Water Tap Size Sewer Tap Size
List appropriate option #s
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) $ , t l/ l u t,!'id
Description of Work: -y;;e
I nC'LLk0'0--
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
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 CCo�lli s ordinances nd state law regulating building construction.
Applicant Signature (/�'/�4 rint Name GL 1 r 7�" fir%' ?-' Phone q70 6T2'2-t5.S
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE