HomeMy WebLinkAbout3051 Sage Creek Rd - Applications/Basement Finish - 12/05/2014Fort Collins
APPLICATION
Job Site Add
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
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BUILDING PERMIT APPLICATION
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_ Unit # (31 Li l
PROPERTY 9MER INFO. (All owner information Is required - it'-I,s_not optional) Phone #17(� 2l- 47
Last name 0 First Name > &"N(x _ Middle
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CONTRACTORJNFO:'CompanyName Bt_l_ I_`r 6u"lw Contractor Phone# �] 0-53y -005
Lic Holder Name WeS c, I I lylnLr+�— City of Fort' Collins License # D- IRQ1 Supervisor Cert #
Mailing Address_'5: 5CJ W o- j4i � t p`b - � City,6 /--c-Gd� / State &0 Zip
LEGAL INFO: ,
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (ial6a6ding biiiemefit) Total Garage Sq Ft _
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1" Floor Sq FC: 2n0 Floor Sq Ft 3'" Floor Sq Ft Unf!ished Bsmt Sq Ft 95a
Finished Bsmt Sq Ft -I CO # of Bedrooms # of Full Baths % Baths 'Fi Baths # of Fireplaces
Air CondWoninq. Ye lo� (� Energy Info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door l l4. Simulated Performance Alternative ❑ 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
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UTILITIES INFO: f
'Water Tap Size Sewer Tap Size Metered: Yes ❑NoO Temp. Pedestal Yeso No ❑
Type of Heat ❑Gas nElectric Electric Main Breaker Size (Residential only) 1:1150 Amp or Less ❑200 Amp ❑Other
Value of Construction (including labor, material &,profit)
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Contact Name & Phone # of JOBSITE SUPERVISOR:
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Electrical ,` l �\ JMechanical l I - I'tf7 / V1t�( I plumbing
Framer Bcj LL' �_ Roofing "�� Concrete `-1 Fireplace �--
Solar —�� Other Other Other
Applicant: I hereby acknowledge that I have read this application and state that the above information is coned and agree to comply with all requirements
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Applicant Signature - Print Name 1 Ik{�11 Phone 9yy�� nA 53L4 -
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Distribution: White -Office Yellow -Applicant Pink -WANV/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE -