HomeMy WebLinkAbout2303 Strawfork Dr - Applications/Basement Finish - 12/13/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
APPLICATION
Job Site Address
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION DATE 13 1 V� i ) (Y
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phonne# 20 -632 - 02-/ 7
Last name Nd. ,oY-N First Name 1, 1 ri-A ✓r `l /- jW1'fi(% Middle / � �i
Street Address ,�c 30 3 5t(�' O(4L D� City �7 C. M, h S State 60 Zip O S ZS
CONTRACTOR INFO: 1Company Name �1^OG,iv� t-e'vur � Contractor Phone #
Lic Holder Name ( 1 � [ram\ Z /, e, City of Fort Collins /License ; % 7 / Supervisor Cert ##j
Mailing Address 5 3 G Sk�(�t/u + !2� City L-O/�/1 �5 State (-fl Zip
LEGAL INFO:
Subdivision/PU
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft
181 Floor Sq Ft
Finished Bsmt Sq Ft -7U
Comm] Sq
2nd Floor Sq Ft
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
31d Floor Sq Ft
# of Bedrooms 1 # of Full Baths l 3/< Baths
Unfiished Bsmt Sq Ft *)
/z Baths # of Fireplaces
Air Conditioning: & 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 3 Metered Yes or No Temp. Pedestal Yes or T
Type of Heat: ® Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less `J�1200 Amp ❑ Other
Value of Construction (including material & profit) $
Desc:rintionofWork' l ,I^I<I�(
1) h/.i�if�'1 ! 7O� -
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
L) I k
Electrical e bij) �P E/e Mechanical 13 ill I✓t
Framer Roofing Concrete
Solar
Other
Other
7v S6
Plumbing ��1� /Vh�r✓/`
Fireplace
Other
Applicant: I hereby acknowledge that I has ad this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Co io inan and state laws regulating building construction.
Applicant Signature �� Print Name 1 /�e�(�(/ ��% ? Phone 97y
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Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE