HomeMy WebLinkAbout936 Deerhurst Cir - Applications/Basement Finish - 08/10/2017City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER ?:1—iu4 `,� L APPLICATION DATE di in I I /
Job Site Address9�� 1z1lua_ ST �tli2 �,.��5 Unit #,
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # J 79 5y 5tJ0yL—
Last n
Street
CONTRACTOR INFO: Company
Lic Holder Nar
Mailing AddreE
LEGAL INFO:
First Name s3 'Z_ __ Middle
City��J����/'U State_zip
Contractor Phone#-�7//7Q
y of Fort Collins License # zt ` ' C - Supervisor Cert
City �h. >2 �_ State zip
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) / , 03 Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
1s' Floor Sq Ft
2nd Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3rd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms 3 # of Full Baths % Baths _I '/z Baths # of Fireplaces
Air Conditioning: YerNo� Energy info:( Circle appropriate choice) 1.ComCheck11 2. ResCheck w/Air Sealing 11
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[] NoF-1 Temp. Pedestal Yes❑ No ❑
Type of Heat: DGas1-1 Electric Electric Main Breaker Size (Residential only) 1:1150 Amp or Less 200 Amp DOther
Value of Construction (including labor, material & profit)
Contact Name & Phone # of JOBSITE SUPERVISO tiJ 'ir 70 -G -
Subcontractor Info: //%�
Electrical dk Mechanical /«iLrl tJl= Plumbing
Framef7!`// itVt,;�Lit=NJ Roofing Concrete Fireplace��
Solar Other Other Other
Applicant: I hereby acknw��ge�jtj� d this application and state that the above information is correct and agree to comply with all requirements
contained herein and Cityo rrtt� s inances and state laws regulating building construction.
Applicant Signatur � Print Namee)h� L i`1�1 '{� Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE