HomeMy WebLinkAbout3813 Kentford Rd - Applications/Basement Finish - 03/24/2017City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760
www.fegov.com/building
f BUILDING PERMIT APPLICATION
APPLICATION NUMBER I APPLICATION DATE
Job Site Address / - Unit #L/(j]
PROPERTY OWNER INFO: All owner information is required— it is not optional) Phone # vl � -6i (b -69 r
Last Firs(�t Nam' Middle 7 �_
Stre to Addre rl � t �J City) FoFI I01 e (�'Q Z�
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cart #
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
(CONSTRUCTION-INFOa Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq Ft
lent) Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
161 Floor Sq Ft 2nd Floor Sq Ft 31d Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft _,3 �4•of Bedrooms A # of Full Baths '/. Baths '/� Baths # of Fireplaces IdA
Air Conditioning: Yes No 7 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:
Water Tap Size Sewer Tap Size
List appropriate option
Metered: Yes or N
Type of Heat: ❑ Gas ❑ Electric Electric Main Break; $ize (Residential only)
Contact Name 8 Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Mechanical
Concrete
Other
o Temp. Pedestal Yes or No
❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge that I h e ad this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Ili or ces and state laws regulating building construction. / /
Applicant Signature I rPiinfName I / P� e 1 f0 ,5
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE