HomeMy WebLinkAbout3500 Carlton Ave - Applications/Basement Finish - 02/27/2017COMMUNITY 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-"1 — l I 1 APPLICATION DATE FEB 2 7 2017
Job Site Address 7500 CAf-L-170J AVE. AlN4Z Unit# N42-
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
` MAKE wAqtjf
Last name W 19Q6+r15 First Name V 1C-ioR1A Middle L-yNO
Street Address 3560 OA KCTo 0 A.r f 0 1-1Z City F-e_ Col.- -I tas State CO Zip 9'O15 2 5
CONTRACTOR INFO: Company Name 5ELr— Contractor Phone # q70 `a13—g H8�
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
City of Fort Collins License # Supervisor Cert #
City
Filing # Lot #.
State Zip
Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm] Sq
1 s' Floor Sq Ft 2nd Floor Sq Ft _
Finished Bsmt Sq Ft qnoli_ # of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
# of Stories Bldg Height # Dwelling Units
3rd Floor Sq Ft Unfiished Bsmt Sq Ft 130
Z # of Full Baths-e- 3/<.Baths Baths # of Fireplaces "(�)—
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
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 /S�izee (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 129 I t UV3. 1 0
Description of Work: A FTE(t Tilg FACT PA5Et-AEwr r t PtLs4_
Contact Name & 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 ollins ordin ces and state laws regulating building construction.
Applicant Signature /� Print Name MAP,K- W IDDOtWS Phone 7C),2L3-44�4j
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE