HomeMy WebLinkAbout816 Brookedge Dr - Applications/Basement Finish - 01/24/2017City 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 t / / Ol / 3 / 9 APPLICATION DATE I cN-
Job Site Address A 16 130=Kc c- a- Unit #.
PROPERTY OWNER INFO: (All owner information Is required - it is not optional) Phone # 9%0'-219 -1Z67
Last name �First Name :rS A 1-- /� Middle
Street Address Sib Rjen ei�r.,� Die. City 1—T C?icy-" V 2o StateSj:�P Zip 5
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 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 31 Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft -755 # of Bedrooms # of Full Baths % Baths '/z Baths 7;> _ # 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 Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (CRIesidentiall only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
II
Value of Construction (including labor, material 8 profit) $ �� 6 &• 0t
Description of Work: F//4/1--�14E"n i3ASEaLLC'�il'
Contact Name 8 Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
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 of Fort Collins%ordinances and state laws regulating building construction. ,�!
Applicant Signature lJt Print Name � Imo/ Al /V`Y4 so Phone VQ 2lot-(35-7
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE