HomeMy WebLinkAbout5607 Pleasant Hill Ln - Applications/Basement Finish - 05/07/2012City
}off COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6Collins 281 N. College Ave. • Fort Collins, CO BOS24 a Phone: 970-416-2740
wwm0agov.eomlbullding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER l ' �. 6 1 APPLICATION DATE
Job Site Address 56617 P14VASAiVT (6/tG L n/ Unit #
PROPERTY OWNER INFO: (All owner Information Is required — it Is not optional) Phone # f70— °Z 2 (o --5e171
Last name !y/�LSE/I/ First Name GCORfiE Middle
Street Address 5L 0'7 I L�'/�SANT N /GL LN City iff Coi CIA(S State & Zip
CONTRACTOR INFO: Company Name
Contractor Phone #_
Lic Holder Name City of Fort Collins License # Supervisor Cart #
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD &eg 6-5TA7E5 TUD Filing # Lot #_L Block # Lot Sq Ft ZA0, 174
CONSTRUCTION INFO: Total Building Sq Ft (nut including basement) cZ 3 Il ( Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Z Bldg Height # Dwelling Units
1� Floor Sq Ft 2n0 Floor Sq Ft 3id Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft tb-t # of Bedrooms # of Full Baths % Baths '/: Baths # of Fireplaces
Air CondhYoning. Ye& Energy Info: (Cinxe appropriate dwioe) 1. ComCheck ❑ 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 6. Prescriptive w/Air Sealing11
6. Prescriptive w/ Blower Door)
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes E]NoE] Temp. Pedestal Yes❑ No ❑
Type of Heat: ❑ Gas Electric Electric Main Breaker Size (Residential only) 1:1150 Amp or Less1:1 200 Amp DOther
L Value of Construction (including labor, material & profit) $ I I r -06I
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
Fireplace
Solar Other Other Other
Applicant: 1 hereby admowl 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 of Collins ordinances a state ws regulating building construction.ltr'
Applicant Signature�(/Iti Print Name v e�2v7 e /l/I��S�ti Phone ;� 7 �/
Distribution: White —Office Yellow — Applicant Pink —WVWV/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE