HomeMy WebLinkAbout5042 Snow Mesa Dr - Applications/Basement Finish - 05/12/2015City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER b V 5C6 1 Ic. APPLICATION DATE
Job Site Address3047& !17�hoo ,l�i���t-�sa ✓z- Unit #.
PROPERTY OWNERf_INFO: (All owner information is required - it is not optional) Phone # /
Last name S Vke'o First Name i7c?4 Middle Do"o" I
Street Address /Z 4y4Jt+1 Xt'S),_J)(\A-C" City r� _d/h' 5 State Zip
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address
LEGAL INFO:
Subdivision/PUD
Contractor Phone #
City of Fort Collins License #.
City
State
Supervisor Cert #.
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
1s' Floor Sq Ft
2nd Floor Sq Ft
# of Stories Bldg Height_
3rd Floor Sq Ft
# Dwelling Units
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft i ff-0 # of Bedrooms —0�_ # of Full Baths / % Baths '/2 Baths # of Fireplaces
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 (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 65
L' 15-S-
Description of Work: Q:eaneZl —fv1 dS'7
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontraccttoor/Info: �"
Electrical .SGJI4�/aQi�ckl(G Mechanical
Framer Roofing
Solar Other
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 of s ordina 6es and state laws regulating building construction.
Applicant Signature Print Name / r ✓'-e_ Phone
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE