HomeMy WebLinkAbout509 Cornell Ave - Applications/Basement Finish - 07/19/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
City
Collins
APPLICATION NUM
281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760
www.fcgov.com/building
UILDING PERMIT APPLICATION
154 APPLICATION DATE -7 11 1 1 I o
Job Site Address (500 GOV'ne1j.j /-�,y-e. , Ff, COI l/`1'2-l;" Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # (71W) i50 ` — 4aer—
Last name f� ISeiq First Name C PI Middle
Street Address Q a car4 P/Ayy- City f, CO 1110'P State a Zip ROv5-2-tS
CONTRACTOR INFO: Company Name
Lic Holder Name
Contractor Phone #
City of Fort Collins License # Supervisor Cert #.
Mailing Address City State Zip
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 Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft 2nd Floor Sq Ft V Floor Sq Ft Unfiished Bsmt Sq Ft
1
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths _0 _ 3/ Baths '/z Baths 0 # 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) $
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Lg M 19 Cy/ ! % Mechanical
Framer
Solar
Roofing
r
Concrete
Other
liumbing i 16 II .ti 04I
Fireplace
Other
Applicant: I hereby ackno edge tha a ad is application and state that the above information is correct and agree to comply with all requirements
contained herein and ' y of Fort Co ' n s and state laws regulating building construction. r
Applicant Signatu Print Name 0 ///7 6j�ciu/ uC Phone �� +- +4-J
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE