HomeMy WebLinkAbout2933 Ruff Way - Applications/Basement Finish - 12/08/2016City of COMMUNITY 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 NUMBER " I v—A TL-A',k-) APPLICATION
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PROPERTY OWNER INFO: All owner information is required — it is not o tional Phone #
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Last name(" �� First Name �W (1�� ! Middle
Street Address u City-16 (` j jj,, StateOV Zip �y
CONTRACTOR INFO: Company Name Contractor Phone #
Lie Holder Name
Mailing
City of Fort Collins License # Supervisor Cert #
City State Zip
LEGAL INFO: Subdivision/PUD kY4 Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm] Sq
151 Floor Sq Ft
2"d Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3'd Floor Sq Ft Unfiished Bsmt Sq Ft'
Finished Bsmt Sq Ftof Bedrooms # of Full Baths
'/, Baths /2 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
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker
Value of Construction (includind labor, material & profit) $
Description of:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Mechanical
Metered: Yes or No Temp. Pedestal Yes or No
(Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Roofing Concrete
Other Other
Plumbing
Fireplace
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 Fort ollins oSnances
�yand
�state
ellaws regulating building construction.
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Applicant Signature lD h-^'�F' J Print Name1 1 (c7M�t�--1 i n Phone 5o]?00'0�/1r/.
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE