HomeMy WebLinkAbout2814 Zirkels Ct - Applications/Basement Finish - 10/28/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FortCollins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/build ing
BUILDING PERMIT APPLICATION
APPLICATION NUMBER �A U- V `l' 4 U (p APPLICATION DATE
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Job Site Address 2$1 q 4IF- air C-t; fort colllNS Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #.
Last name c_.;. 1664s First Name IM t CAA S�t--
Middle pa 1704--r"
Street Address 21 1- KE.LS C-4- City e + 60 1 V, K $ State CX1 Zip tel b 'ro
CONTRACTOR INFO: Company Name Contractor Phone # 7 �v `f 3 o -4'8 -' -?"
Lic Holder Name
Mailing Address.
LEGAL INFO:
Subdivision/PUD
City of Fort Collins License # Supervisor Cert #.
City State Zip
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm1 Sq Ft # of Stories Bldg Height # Dwelling Units
15' Floor Sq Ft 2nd Floor Sq Ft 3'd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths %2 Baths IS* # 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:
Water Tap Size Sewer Tap Size
List appropriate option #s
Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) 0150 Amp or Less ❑ 200 Amp ElOther
Value of Construction (including labor, material & profit) $ I ( y j1u - U 1 i
Description of Work: Fj O%S 64 S•A-1;5�MQ ?", %ff AftA C �.I tcdWGO C Pit dal: Q _ 4n r�L A'fiict^ ,
. _ .1 N T
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical QVI C-Ad e10C111C- Mechanical
Framer
Solar
Roofing
Other
Concrete
Other
Plumbing (ZE—k'S f1U'k5;4
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 , `J 91 Phone l lib Y?J ?83:�—
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE