HomeMy WebLinkAbout537 Yuma Ct - Applications/Basement Finish - 07/12/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER iG.J�[,�OAPPLICATION DATE
Job Site Address ��_37 �''ry Jc GA• Unit #
PROPERTY OWNER INFO: (All owner information is required —it is not optional) Phone #
o-- 777-z&
Last name 0 �'G 7VGC� First Name ✓r4_-j Middle
Street Address ���� Yy�'h City�yt/�! State elo zip
CONTRACTOR. INFO: Company Name-;�/1174u61i4 Contractor Phone #
Lic Holder Name J/A" City of Fort Collins License # >>Z— 3 Supervisor Cert #�Z
Mailing Address Gil I City, or/ W/ State zip
LEGAL INFO:
Subdivision/PUD Filing #.
CONSTRUCTION INFO: Total Building Sq Ft (not including basement
Residential Sq Ft Comm'I Sq
15' Floor Sq Ft
2nd Floor Sq Ft
Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft 70-0
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths "Y40 % Baths W® '/2 Bathgv P # 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 #s
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, /m'aterial & profit) $ 6p
Description of Work:�lil1 S17 P� /20-e xn GG '� .2 v4'�
it
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical el�G/_1'/6_ ICS " _ Mechanical XivIl we r'r` 7 G%� i/�� Plumbing A%
Framer!KAI IL-A)4 Roofing Concrete Fireplace
Solar
Applicant: I hereby acknowli
contained herein and City of
Applicant Signature
Other
Other
Other
I have read this application and state that the above information is correct and agree to comply with all requirements
is ordinances 943tate laws regulating building construction.
Print Name
Phone
/ Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
J THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE