HomeMy WebLinkAbout3933 Oak Shadow Way - Applications/Basement Finish - 11/15/2017City 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
p In BUILDING PERMIT APPLICATION
APPLICATION NUMBER I `' "' 9 � APPLICATION DATE 111I"/ I I-7
Job Site Address
Unit #
1-0 Kr U u i ULfJM';,, L U VVV2z� 0
PROPERTY OWNER INFO: (All owner information is required - it isI C not
opttiio,,nal) Phone #
V Last namemilai First Name `/1 U . &J Middle Q
Street AddressW5' I L City - \ /� 'b] L N-12 Sta tef 0Z i fl / `�
7
CONTRACTOR INFO: Company Name D W Nv� a Contractor Phone #
Lic Holder Name
Mailing
City of Fort Collins License # Supervisor Cent #
City
LEGAL INFO:
Subdivision/PUD I'Y1c�.Le.aUcis Cu2 Filing# Lot#
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm] Sq
151 Floor Sq Ft
2nd Floor Sq Ft
# of Stories Bldg Height
31d Floor Sq Ft
State Zip
Block # Lot Sq Ft
Total Garage Sq Ft
# Dwelling Units
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft I I"J z # of Bedrooms I # of Full Baths I -/< Baths /z Baths # 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:
List appropriate option
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) $ D 1 -70 V
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: n. 1 I ^ n
Electrical
lll V M� 1W �IL l �r b Mechanical -FC �l f Plumbing 0 �
Framer VbUK)-ex— Roofing Concret Fireplace a
Solar
Other
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 9f Fort Collins ordinances and state laws regulating building con(nstruction..�I
Applicant Signatur I ft.WPrint Namk)C lrj%v�1 y V h� Phone ql 4I2
Distribution: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE