HomeMy WebLinkAbout3156 Rock Park Dr - Applications/Basement Finish - 01/30/2017City of I I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. - Fort Collins, CO 80524 - Phone: 970-416-2740
www.fcgov.com/building
�1 ( (\� 1� BUILDING PERMIT APPLICATION
APPLICATION N
APPLICATION NUMBER � 1 1, 0 )mot L� APPLICATION DATE I l w r1
Job Site Address i A'r�- bilkVi o-f ('%A�v5 Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # (!/ T02 Y 2 r
Last name e� h
Street
31 bIoc'&-I
CONTRACT FNIRO O Company Name
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
First Name 'DA"1^ Middle
r
City('� 6AYlkA-JS State 60 Zip JD Z. 7
C
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
City State Zip
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm9 Sq Ft # of Stories Bldg Height # Dwelling Units
151 Floor Sq Ft
2nd Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished (oB# o�B sth3/B s)y /:Basy Fireplaces
Air y
Conditioning: Ye�Non 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 #
List appropriate option
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes []No[] Temp. Pedestal Yes❑ No ❑
Type of Heat: ❑ Gas1-1 Electric Electric Main Breaker Size (Residential only) —1150 Amp or Less ❑ 200 Amp DOther
Value-o�ction.(including labor, material & profit) $
Description of Work: (1y(S 14- l �3t-0 k?-nivv- / ( evert- f�A-r I4 A i3 A2 /42. , 4
Contact Name & Phone # of JOBSITE SUPERVISOR:
,Subcontractorlr fo
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 coned and agree to comply with all requirements
contained herein and City of Fo Collins ordinances and state laws regulating building construction.
Applicant Signature / � Print Name t'/IA CAV-,P Phone &3uYyY Y2.�/
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater