HomeMy WebLinkAbout6357 Carmichael St - Applications/Basement Finish - 04/21/2015City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
wvvw.fcgov.com/building
GBUILDING PERMIT APPLICATION
APPLICATION NUMBER1 �J 1 APPLICATION DATE
Job Site Address g 35 Z C Q fm I"r � 'e g L57" ra& L(ni ,'ins C- U�j t5
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #
Last name— �~R 19 & First Name 1 l ' ► I J Middle
n •' /�
Street Address Pity 1 State 6 Zip
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing
LEGAL INFO:
Contractor Phone #
City of Fort Collins License #.
Subdivision/PUD Filing #.
Supervisor Cert #
State Zip
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
1 s' Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft �� # of Bedrooms # of Full Baths 3/< Baths % Baths # of Fireplaces
20d Floor Sq Ft
31d Floor Sq Ft
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:
List appropriate option #s.
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker
/Size
(Residetial only) ❑ 150 Amp or Less ❑ 20o Amp ❑ Other
Value of Construction (including labor, material & profit) $
Description of Work:—{'InlS11 Y qj (y� 4;Q �—[—
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 Collins ordinances and state laws regulating building construction.
Applicant
Print Name
Phone
Distribution: White —Office Yellow —Applicant Pink—WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE