HomeMy WebLinkAbout4233 Applegate Ct - Applications/Basement Finish - 05/03/2017City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1171 () � APPLICATION DATE MAY O " 2017
Job Site Address yZ33 Ae G*• Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not opti nal ) Phone # ':�v l0'3 1 oqot0 Z
Last name /d��/r%i�} i\ ,, _ D First Nam ,, / /la Middle /
Street Address gZ�23 Q1aJ�i (iJ� � City 1�=� (� �{fY►5 State ' _Zip �OsZ(�
CONTRACTOR INFO: Company Name j?j'� 1,Cd 6Zorlsn Co &5i . ` Contractor Phone # C170 410 a4rl-7
YI A Lic Holder Name ✓QI� j��� %1- City of Fort Collins License # n %0� Supervisor Ce�,
Mailing Address 1 `� 13 o derlek:5 � � 2 - City Fi( !__O//170 State d D Zip p6cj Z 49
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
1st Floor Sq Ft
2"d Floor Sq Ft
3•d Floor Sq Ft
Finished Bsmt Sq Ft 1607 # of Bedrooms 030- # of Full Baths
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Unfiished Bsmt Sq Ft /01-�
'/. Baths --L- '/z Baths # of Fireplaces
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
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, material & profit) $ 49.c6n
Description of Work: Cr Nt;. 5/4• 1110
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: / ,f� / / //
Electrical L�tl1���� /� Mechanical 2>L141 AO A Y�s4 Plumbing � v /
Framer�/� I S1�� Roofing �� Concrete /7 �� Fireplace t I t -S t1-✓�
Solar Other q A Other 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
Collings ordinances and a laws regulating building construction.
Applicant Signature — I rt /�U� f�V Print Name aARAI, We I'S &-n Phone4r7O 2-le 12[77
Distribution White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE