HomeMy WebLinkAbout844 Courtenay Cir - Applications/Basement Finish - 01/26/2017City of
I I 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 00y, 1 APPLICATION DATE I I R u l a
Job Site Address bqq ��� enay (Si rr.(p- Unit #,
PROPERTY OWNER INt,F1O: (All owner information is required - it is not optional) Phone # 976- Na-03 - 76S
Last name � 9y� First Name U-1, Yor. L:e- Middle A
At/
Street Address O (Y ixV4t. toy C tic e- City Fcej 60%.", 5 State`zip S-OSo-ii
CONTRACTOR -INFO: -Company Name
Lic Holder Name
Mailing Address
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Contractor Phone #
City of Fort Collins License #.
Filing # Lot #
Supervisor Cert #,
State
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft 2"d Floor Sq Ft 3'd Floor Sq Ft /Unfiished Bsmt Sq Ft'
------------
(—Finished smB t Sq F� (# -of Bedrooms L # o�Baths IJ6 '/. Baths '/: B to hs _ # of Fireplaces X
_1
Air Conditioning: Yes No Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
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 8 profit) $ �at3 1, a� 0' 00
r-- f I
t Description of Work: / t n. � /inr"4►.
Contact Name 8 Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Elec` trical '/r�Ss.j w^cel &t Mechanical Plug— tubing
Framer
Solar
Roofing
Other
Concrete
Other
Fireplace
Other
Applicant: I hereby acknowledge that I have read this application and slate that the above information is correct and agree to comply with all requirements
contained herein and City of rt ollinss ordinances and state laws regulating building construction. y�
ApplioantSignature_�"y �n-v � Print Name at& Svv.'O I„ Phone 17elol0-7361-
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE