HomeMy WebLinkAbout738 Campfire Dr - Applications/Basement Finish - 04/29/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
CollinsFort C281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER t5 l V1Q;�; Z JQ APPLICATION DATE 4 ' P-Cl ' I
.Job Site Address3 �Ga�-c p �,✓P_ )� l Unit #
PROPERTY OWNER INFO: (All owner information is required - it is noti optional) Phone #
Last name AL First Name I-e9 � Middle
Street Address 3 9 17 r City LQ 3`/� 111 N 5 StateZ0'—,—'—Zip g a SZ l-
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
Contractor Phone #
City of Fort Collins License #.
City
Filing # Lot # 6
Supervisor Cert #.
State Zi
Block # 2 Lot Sq Ft 1;-", O 1 1 sl� #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft L� "Momm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1IS Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft
Finished Bsmt Sq Ft 6o 3 # of Bedrooms 40 # of Full Baths % Baths
Unfiished Bsmt Sq Ft
O '/2 Baths # of Fireplaces Ae"o—
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:
Water Tap Size Sewer Tap Size
List appropriate option
Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Resider};'I only) ❑ 150 AmporLess ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $C���_
Description of 1
/l� i' i 1; vl
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
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.
Applicant Signature Print Name A, �'/ / .�I Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE