HomeMy WebLinkAbout3500 Rolling Green Dr - Applications/Basement Finish - 08/23/2017COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBERIN ALPPLICATIO-- N DATE
J� ob _$ite Address "'�SDo tea �w1. �Z�t� Qa- Unit # j1 q c1
PARTY OWNER -INFO- (All owner information is required — it is not optional) Phone # /1
Last name lo%coo) o^J First Name b^%J) n Middle
Street Address y1 �`� &m AV-U L• City ouL.6ivy - State Cc9 ZiO
CONTRACTOR'NFOoName /OLPL
CmContractor Phone #
Lic Holder Name
CwQ" I
loo(.00 V
City of Fort Collins License # L= 311 Supervisor Cart #
Mailing Address
S.
City I-t7V 'L FgArA State C,0 Zip 50S'39
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO' Total Building Sq Ft (not including
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft I # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
2nd Floor Sq Ft
3`d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft U f # of Bedrooms # of Full Baths - '/,Baths '/� Bt aths l # oases,
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 #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) $
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Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
,Electrical- i�Ny w�?
�(,NIIA wechanical
C-Plumb nl g W iA%,u 6L
f l.w-. 1WU
Framer
Roofing Concrete
Fireplace
Solar
Other
Other
Other
Applicant I hereby acknowledge that I have read this applica n and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins nances and e I s regulating building construction �•
App� Signature Pnnt,Name !Phone c—oglj-ig L}
Distribution White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE