HomeMy WebLinkAbout2909 County Fair Ln - Applications/Basement Finish - 03/17/2015City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort+t Collins 281 N. College Ave. a Fort Collins, CO 80524 • Phone: 970-416-2740
wwm0egov eom/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER FD1-5QQ-t APPLICATION DATE
Job Site Address 2�1 /,s��, �cr:s �,� Unit #
PROPERTY OWNER INFO: (All owner Information Is required- it is not optional) Phone*
Last name Lswe�c First Name ��- / f- /'%SA . Middle
Street Address 2::ftr"%r '47 �1city�� State Zip
CONTRACTOR INFO: Company Named /-� 1":44qv1 Contractor Phone #C970) �� 'y79W
Lic Holder Name -9Ze 14i n'0e4 lwr City of Fort
�Collins License # Supervisor Cert #
Mailing Address 11Z3 %%%v�o-s�4� G'f City / X 4 /v// State Ca Zip
SubdivisiorgPUD 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
V' Floor Sq Ft
2nd Floor Sq Ft
3n° Floor Sq Ft Unfiished Bsmt Sq Ft 0
�r
Finished Bsmt Sq Ft %� # of Bedrooms L # of Full Baths % Baths / Y. Baths # of Fireplaces
Air Conditioning. Yeto
Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck wBlower 4. Simulated Performance Akemative❑ S. Prescriptive w/Air Sealing[] 6. Prescriptive w/ Blower Door[
City of Fort Collins Stock Plan #
List appropriate option #s
Water Tap Size Sewer Tap Size Metered: Yes ❑No❑ Temp. Pedestal Yes❑ No ❑
Type of Heat: ® Gas nElectric Electric Main Breaker Size (Residential only) 0150 Amp or Less ❑ 200 Amp ❑Other
mo
Value of Construction (including labor, material & profit)
Description
Contact Name & Phone # of JOBSITE SUPERVISOR: �9�a% sd6- Z7p8
Electrical !ry r�l Mechanical iOeii y-//,/ y, Plumbing eW v.
Framer Roofing Concrete y�� Fireplace
Solar
Other
Other
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 ulating building construction. / / �)
Applicant Signature //� �G Print Nam e// l / —,ta o14l&r Phone(
Distribution: White -Office Yellow -Applicant Pink -WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE