HomeMy WebLinkAbout2062 Blue Yonder Way - Applications/Basement Finish - 08/20/2018CityofCOMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
ForrCollinsC t ll281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION �1
APPLICATION NUMBER ; I v v U Ct 19 APPLICATION DATE v k I ?/
Job Site Address aQ (r,a P)1LhC. `(onder �AjDq Unit#.
PROPERTY yOWNER INFO: (All owner information is required - it is not optional) Phone # q 7O — -� a ^ 93 l7 a
Last name t) (3 n+-o. FirstName NaOMIJ `t- R ryl�Fl Middle
Street Address a (� (� a 8 kA C. YDn cie-G VV Qy City Foci ll� U (n S State ---(-*'_Zip O 5 2
CONTRACTOR INFO: Company Name Ku I ens K� d Q IV) C Contractor Phone # Q `70 3 4 S3
Lic Holder Name A` ` t /A cyA c K t City of Fort Collins License # cab 5 Supervisor Cert #
f�p
Mailing Address -I � I YV 10 ax S+ City FO C( CD li R1 State CO Zip ®O S :�t
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft
1s' Floor Sq Ft
Finished Bsmt Sq Ft
Comm'I Sq
2nd Floor Sq Ft
# of Stories
31d Floor Sq Ft
Bldg Height # Dwelling Units
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/< Baths /z 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
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) $ 1 �'i _ -tT oo . 00
Description of Work: 4- ii3 O SF
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical AK E(ecj r t c Mechanical
Framer
Solar
Roofing
Other
Te-0-V"
Concrete
Other
Plumbing CD[ocaao Ph m6inn
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 offF�Fort
�/Collins ordinances and state laws regulating building construction.
Applicant Signature C� Print Name M �'\ U V Y15 K, ( Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE