HomeMy WebLinkAbout2309 Thoreau Dr - Applications/Basement Finish - 03/29/2018City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
wvvw.fcgov.com/building
BUILDING PERMIT APPLICATION
2
APPLICATION NUMBER-4 APPLICATION DATE J_ C I
Job Site Address a3o� Tq0f.eFw O(L. Unit #
PROPERTY OWNER INFO: (All owner information is required— it is not optional) Phone # 3 o-}-- i 6-o ' o . } O
Last name �3U!?=L1} First Name )A iz V, Middle MA.tn
Street Address a10S TWLEAt1 City j T• OVA-1 ,.sS State oo zip LA
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO: Q '\
Subdivision/PUD U��� nAPLC— kAu L, Filing # t1 Lot #�— Block # I. V Lot Sq Ft `U
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) I�} C�rj Total Garage Sq Ft (04
Residential Sq Ft Comm'I Sq Ft # of Stories _ Bldg Height # Dwelling Units
ls' Floor Sq Ft
2nd Floor Sq Ft 3'd Floor Sq Ft Unflished Bsmt Sq Ft ��
Finished Bsmt Sq Ft # of Bedrooms _V_ # of Full Baths A— '/< Baths 16 '/z Baths _?K # of Fireplaces 0
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: K Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ;X 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 0o , O L)
Description of Work: W FO-t_ 3ATN AIjD �L� �B�Q-L" 1n3 3AS�M��►�
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge at 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 ollins ordinances and state laws regulating building construction.
Applicant Signature Print Name S q(.� SQQX t Phone 3m-�60 ma-b
Distribution: White — Office Yellow— Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE