HomeMy WebLinkAbout2975 Neil Dr - Applications/Basement Finish - 08/01/2017CityofCOMMUNITY 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 tFD I��/ �(' APPLICATION DATE ??' I �- 1-7
Job Site Address
01 Unit #
PROPERTY OWNER INFO: (All owner information is required - it isnotoptional) Phone #
Last name / V I (First Names ) `f�2. Ve Middle T ill-, 0 yh Ql
Street Address l City f—�OP'f� �o I) ) i), f State. (-a ..Zip
CONTRACTOR INFO: Company Name UJA Contractor Phone #
Lic Holder Name
Mailing
City of Fort Collins License #.
City.
Supervisor Cert #
State Zip
LEGAL INFO:
Subdivision/PU ra l 1 ��� � � C Filing # Lot # Block # Lot Sq Ftl (03 64j>-
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft j Comm'I Sq Ft # of Stories_L Bldg Heigh t# Dwelling Units
1 s' Floor Sq Ft 6 1. (() ~/ 2nd Floor Sq Ft 3'd Floor Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft L # of Bedrooms # of Full Baths Baths /z Baths # of Fireplaces L
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 # List appropriate option
UTILITIES INFO: d
Water Tap Size Sewer Tap Size_ Metered: es or No Temp. Pedestal Yes or
Type of Heat: �&s❑Electric Electric Main Breaker Size (Residential only) El150 Amp or Less X200Amp ❑ Other
Value of Construction (including labor, material & profit) $ �i -1
Contact Name & Phone # of JOBSITE SUPERVISOR:
-a�o (j -- �5-1
Subcontractor Info: p
ri J {:e a�ef 3 C
Electrical Q ' 'e M.echhanicalk1/ Plumbing ' )�G1 da
Framer Roofing 1V Concrete Fireplace
Solar Other Other Other ZA
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 A AA'&e%'-C Print Name 5i>dveMae6iQ- Phone 976 ggZ-S6-T9
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE