HomeMy WebLinkAbout4714 Prairie Ridge Dr - Applications/Basement Finish - 04/03/2015COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
City of
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER v b Z I l I APPLICATION DATE 4-3- 1 5
Job Site Address 4:j-I� ?MfLi s Kll%= �),L Unit #,
PROPERTY OWNER INFO: (All owner information is required- it isnotoptional) Phone # �10 - SS- 60 - 2 (S
Last name d ASL'R s First Name Middle
Street Address ��)H � ljt)4� 9i)1,F D?- City er Cot.LINS State -(—Zip 6019 o
CONTRACTOR INFO: Company Name hoyVIC (,)L l AJis;fL Contractor Phone
Lic Holder Name City of Fort Collins License # Supervisor Cert #.
Mailing
LEGAL INFO:
City
State Zip
Subdivision/PUD AIu n,2A)A 3(o s Filing # Lot # 3 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 2ntl Floor Sq Ft rd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft J691W # of Bedrooms # of Full Baths 3/, Baths &P�01/z Baths -*—W # of Fireplaces —
Air Conditioning: Yes N Energy info: (Circle appropriate choicf) 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 #
List appropriate option
UTILITIES INFO:
It
Water Tap Size 3��[ Sewer Tap Size Metered: Ye or No Temp. Pedestal Yes or N9
Type of Heat: 6Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less .K 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ = i�3E3' 7 (o Lp, oD
Description of Work: rl/wb" Or�T ?o fx D i-Lvvu1 8'.)t f:vtt T11 �orn
Contact Name & Phone # of JOBSITE SUPERVISOR: V=0 Adl)!A N-\IUMLS 9 TO - 7-5'� - Ztfl 3 Z
Subcontractor Info:
Electrical Mechanical tTywr✓d\L Plumbing �ir%M,roW.ve�
Framer Roofing tir Concrete ti�� Fireplace NLA
Solar N)A 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 regulating building construction.
Applicant Signature Print Name Phone
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE