HomeMy WebLinkAbout725 Columbia Rd - Applications/Basement Finish - 01/02/2015City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER I V v 1 `I APPLICATION DATE f I 1
Job Site Address �+ Z S (z, lu,,,,5 i A KoJ., F+C, Co, BDSa Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # R J-0 ZZS
Last name rAO'C'4- I_GI!'peI�e^ First
Street Address ZS� C0�u Yia J
1a� ¢ lLCre.�,
Middle
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City Imo r+ CO M ^S State CID Zip to S Z j'
CONTRACTOR INFO: Company Name 11AContractor Phone # q qa' z-_-S (6j
Lic Holder Name ftW 00 N 14 City of Fort Collins License # Supervisor Cert # —
Mailing Address City State Zip
LEGAL INFO: fgrce� q�ayY—is 086 Al., b,I,uocP�F19fi2`( �o L�cr;wr•Co.45ultorweSsFe
Subdivision/PUD 2S Z Co-br wce c9 Filing # ' c Lot # Block # Lot Sq Ft --�g 8 L/
CONSTRUCTION INFO: Total Building Sq Ft (not Including basement) J Zg I Total Garage Sq Ft G y 3
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units c�[-
151 Floor Sq Ft 2"d Floor Sq Ft 31d Floor Sq Ft Unfiished Bsmt Sq Ft 14 u t
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/a Baths '/ Baths # of Fireplaces
Air Conditioning: Ye4oH 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 #
List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes 19No❑ Temp. Pedestal Yes❑ No ❑
Type of Heat: @ Gas ❑Electric Electric Main Breaker Size (Residential only) ❑l50 Amp or Less ❑ 200 Amp ❑Other
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Value of Construction (including labor, material & profit) $ S I Lp I
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Contact Name & Phone # of JOBSITE
Subcontractor Info:
.Electrical
Framer
Solar
Roofing
Other
IRVISOR:
Mechanical
Concrete
Other
r
_ %ur Bing
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 Signature /'l �L�` Print Name %cti'P'l Phone
Distdbution: White -Office Yellow -Applicant Pink-WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE