HomeMy WebLinkAbout3005 Ross Dr - Applications/Basement Finish - 08/25/2015COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F®rt Of
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1,50 M �� APPLICATION DATE O
Job Site Address f06 s l�r-���� jr. 1 q
Unit #
PROPERTY OWNER INFO:_ (All owner information is required - it is not optional) Phone #
Last names""' First Name I/�9sr/'�'G {
Middle
/ 1
StreetAddress,Sef'i- Z5S fir', j�24 City tsf _ �h�S
-
State�Zip S_>- .�
CONTRACTOR INFO: Company Name 6/ - Contractor Phone # 30 — -7/ -7 - 7 3/c�
Lic Holder Name City of Fort Collins License #
Supervisor Cert #
Mailing Address City
State Zip
LEGAL INF
Subdivision/PUD Filing # Lot #
Block # Lot Sq Ft
CONSTRUCTION INFO: otal Building Sq Ft (not including basement)
Total Garage Sq Ft
Residential Sq Ft m'I Sq Ft # of Stories Bldg Height
# Dwelling Units
16' Floor Sq Ft 2°d Flo Sq Ft 3r1 Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedroom # of Full Baths '/ Baths
'/2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: ( Cir appropriate choice) 1. ComCheck
2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Al ative 5. Prescriptive w/Air
Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List ap opriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes 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) $�/ !9�
/��D•
a
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR: >: tzi
Subcontrac/tor Info:
i
Plumbing
Electrical Mechanical 5
Framer Roofing Concrete
Fireplace
Solar Other Other
Other
Applicant: I hereby acknowledge that I aG read this ppG qation and state that the above information is correct and agree to comply with all requirements
contained herein a Ey of For so na c and st to laws regulating building construction.
Applicant Sign2tnre—...s�
� Print Name GK / Phone �31'7/ - -;75l '
c- i
�Btst ' tion. White - Office Yellow -Applicant Pink - WWW/Slormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE