HomeMy WebLinkAbout830 Marble Dr - Applications/Basement Finish - 11/06/2015�F,t Collins
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER B 50 _"C (yF APPLICATION DATE
Job Site Address 15b0 N1AK--lz LV-
Unit #
PROPERTY OWNER INFO: (All owner information is required - itisnot optional) Phone #
Last name_ CIAyIDY, First Name •t7w i Middle
Street Address_ 10M ill oir(o(� tiY
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing
City 6& i 011 h15 State CO Zip 72-y
Contractor Phone #
City of Fort Collins License # Supervisor Cent #
City State Zip
Subdivision/PUD_,FauY
SQASon S Filing # yol
Lot # 2,9
Block # Lot Sq Ft
CONSTRUCTION
INFO: Total Building Sq Ft (not including basement)2_�!7I2-
Total Garage Sq Ft
Residential Sq Ft
Comm'I Sq Ft # of Stories
Bldg Height
# Dwelling Units
11 Floor Sq Ft
2"d Floor Sq Ft
3id Floor Sq Ft
Finished Bsmt Sq Ft 1 0 $ 5 # of Bedrooms # of Full Baths
Unfiished Bsmt Sq Ft 11-2;C
% Baths I 'Y, Baths # of Fireplaces
Air Conditioning: YeLlNo Energy info: ( Circle appropriate choice) 1. ComCheck11 2. ResCheck w/Air Sealing ❑
3. ResCheck w/Blower Door H4. Simulated Performance Alternative[]
5. Prescriptive w/Air Sealing❑ S. Prescriptive w/ Blower Dool[
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes ❑No❑ Temp. Pedestal Yes❑ No
Type of Heat: ❑Gas ❑Electric Electric Main Breaker Size (Residential only) 0150 Amp or Less ❑200 Amp ❑Other
Value of Construction (including labor, material & profit) $ 7S `, 2 � alG 0
Description of Work:_ 12iQISP/YYIe11{' hnl* finished hol}hra�V> > f)i�Cyt Yupyl/►s S VyGi� C�oSefS
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical f\ybiLAVI �IP �%�L Mechanical
Framer
Solar
Roofing
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 Collins ordinances and state laws regulating building construction. ` ,L� n /� P Applicant Signature I \1V / Print Name �i�, " u i ' Phone 1Z �j(p )'
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Distribution: White - Office Yellow -Applicant Pink -WWW/Stormwater