HomeMy WebLinkAbout1707 Centennial Rd - Applications/Addition or Alteration - 11/02/2017Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www fcgov conikibuilding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER _ -A -1 0:nctzo APPLICATION DATE 1 1 OZ -- I 1
Job Site Address 1707 Centennial Rd Unit #
PROPERTY OWNER INFO: (All owner information Is required - It is not optional) Phone �>Q— , RRx— -/y�,
// Last name / OA .SO/J%� First Name(n Middle
Street Address ��27 t���f /f%L 7 n City � Q0ZZ A4S- State 00 Zip
CONTRACTOR INFO Company Name Side Ind/ Basement Escape Contractor Phone #970-218-3390
Lic Holder Name Brian Stephenson City of Fort Collins License # 815 Supervisor Cart #
Mailing Address 519 N Overland Trail City FC state CO Zp80521
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Budding Sq Ft (not induding basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
1 a Floor Sq Ft
2nd Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3itl Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths 'A Baths # of Fireplaces
Air Conditioning. Ye�]Nop Energy info:( Circle appropriate choice) 1. ComChedc 2. ResCheck w/Air Sealing 11
3. ResChedc w/Blower Door ❑ 4. Simulated Performance Alternative[] S. Prescriptive w/Air Sealing11 6. Prescriptive w/ Blower Doom
City of Fort Collins Stock Plan #
List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes [—]No[—] Temp. Pedestal Yes❑ No ❑
Type of Heat. ❑ Gas Electric Electric Main Breaker Size (Residential only) 11150 Amp or Less ❑ 200 Amp DOther
Value of Construction (including labor, material & profit) $ 2 -1 00
Description of Work:
Install 1 4'x4' asement egress window per IRG code and Engineedng
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
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
yooff FF Collins ordin n nd state laws regulating building construction.
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Applicant Signature A !// L- Print Name // p/ IQ�N Phone
Distribution: White ! Office Yellow -Applicant Pink -VWWV/Stormwater