HomeMy WebLinkAbout5803 Big Canyon Dr - Applications/Basement Finish - 03/22/2018COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
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BUILDING PERMIT APPLICATION
APPLICATION NUMBER �) I `-' 1 C6LOO APPLICATION DATE 3 2- I
Job Site Address 5803 8i6 GRN'/oN DR. Unit #,
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Q52 - ysy' 03 2
Last name W II) MAN First Name D t AEk Middle --5'AA"E5
Street Address -W03 &6 (-ulyot✓ J)g
City &�l Cout,us
State C.a
Zip 8052P
CONTRACTOR INFO: Company Name 14047Fyw,vFA1
Contractor Phone #
QS2 -YSY-
0 sL 1
Lic Holder Name
City of Fort Collins License #
Mailing Address City
LEGAL INFO:
Subdivision/PUD Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Supervisor Cent #
State Zip
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
ls' Floor Sq Ft
2nd Floor Sq Ft
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft Z 90
Finished Bsmt Sq Ft q20 # of Bedrooms / # of Full Baths 3/. Baths / /2 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 #
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 (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $O
Description of Work: FN1SH SAJF 1Et T / 3/y J3+TH / fNrT SA-R
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: I
Electrical I041E ONdEk` Mechanical �iOMt OWr,/�r� Plumbing 11c)mC (jNS�
Framer NdML NER Roofing
Solar
Other
Concrete
Other
Fireplace
Other
Applicant: I hereby acknowledg 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 Fo Collins ordinances and state laws regulating building construction. t� [/
Applicant Signature Print Name DPRKW 10EVAIVt��N)MV Phone �In TSZ - 0321
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE