HomeMy WebLinkAbout375 Cajetan St - Applications/Basement Finish - 02/28/2017City 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 I �`�u J APPLICATION DATE
Job Site Address
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name LF;'r 7� SOt First Name Ad &VII
Unit #
9qo- 601co-(15-3
Middle
Street Address C�G 1(�- TC (LA l c� CjLU4'74_1��ontractor
� I Iti", Statee7oZip
CONTRACTOR INFO Com any Name — -5 U Phone
Lic Holder Name GV U City of Fort Collins License # - 53 D Supervisor Cert #
Mailing Address CV City �. ll�ts State W Zip�� Z
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] Sq Ft # of Stories Bldg Height # Dwelling Units
151 Floor Sq Ft 2"d Floor Sq Ft 3`d Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft 5,35 # of Bedrooms # of Full Baths % Baths /z 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 # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: VrGas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
0 -Z' �.
Value of Construction cluding labor, material & profit) $ y ( C
D��cripti n of Work:
<(� �G� �"_� V►+ SL' O C %� 3 a s
f) rAtn,v,^- I ii . [�L -11 w n r
Contact Name & Phone # of JOB ITE, SUPERVISOR: AA.6, " f O GV t Ii1�t`_l�% 1 l o-N o o5-0'6
Subcontractor nfo: C tL LL� L( k
Electrical t tL(� &/ 'LL &VLc_. ,bechanical � ot-0 Plumbing
Framer OVJ Roofing Concrete Fireplace
Solar Other Other 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 Zr,'X_�A,
nces and state laws regulating building construc.on.
Applicant Signature Print Name I' �� r (/LL tr Phone 17
Distribution: White -Office Yellow -Applicant Pink-WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE