HomeMy WebLinkAbout1245 Intrepid Dr - Applications/Basement Finish - 10/16/2018COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
City of
�FFort Collins
APPLICATION
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION
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Job Site Address CcA«:�, Cc 20-le,
nit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #
Last name "o, First Name Middle Aae)
Street Address UJLA S ,Y��GQ �� r City �t C','( 0 Kil "�R State --CC zip Sb5 Z.
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing
Contractor Phone
City of Fort Collins License # Supervisor Cert #.
City
State
LEGAL INFO:
Subdivision/PUD�'p r'Nro',�Q Z ' CA, Filing # Lot # Block #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
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Lot Sq Ft
Total Garage Sq Ft
Residential Sq Fomm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
2nd Floor Sq Ft
3re Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft '1 i ) 1111
# of Bedrooms I # of Full Baths
3/< Baths j
'/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
City of Fort Collins Stock Plan #
UTILITIES INFO:
Water Tap Size Sewer Tap Size
List appropriate option #s
6. Prescriptive w/ Blower Door
Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 AAmpor Less ❑ 200 Amp ❑ Other
(—aValue of Construction (including labor, material & profit) $ 1 1 � Lm" r
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR: U
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Subcontractor Info: r� I , 1
ElectricalAr za— C1•eC�{I� Mechanical6(A� (5xC�A JeC r)r�� Plumbing Aouf\kCA• \ VV
Framer
Solar
Roofing
Other
Concrete
Other
Fireplace
Other
Applicant: I hereby acknowledge that I have read this a placation and state that the above information is correct and agree to comply with all requirements
contained herein and Cit f Fort Collins ordi a ce_s a state laws regulating building construction.
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Applicant Signature Print Name-5-.{:�,Iti tftd Phoneel 10 —ers—(o
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE