HomeMy WebLinkAbout4203 Mesaview Ct - Applications/Basement Finish - 06/18/2018City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N College Ave - Fort Collins, CO 80522-0580 - Phone 970-221-6760
www fcgov corn/budding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER �) Iy \J 4 S -1 (9�_ APPLICATION DATE l bJ I b
Job Site Address/--03 ms:jj ,PV.►ew G4yi , couh,, 5 X 0 Unit #
PROPERTY -OWNER INFO _(All owner information is required - it is not optional) Phone #
Last name l pee'), First Name I "C CL�11t+ Middle
Street Address "1 d-C)3 F ,5oi, ft,,e uj COL h_1 City �D r���(r� h 5 State Gc> Zip 8 o.
CONTRACTOR INFO Company Name QCA-�142 r Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address,
LEGAL INFO
Subdivision/PUD
City,
State Zip
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm I Sq Ft # of Stones Bldg Height # Dwelling Units
151 Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq� Ft I+ 6 [# of Bedrooms ,� # of Full Baths _-4 '/< Bathsw '/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 #
UTILITIES INFO
Water Tap Size Sewer Tap Size
List appropriate option
Metered Yes or No
Type of Heat ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only)
Value of Construction (including labor" material & profit) $ O O 0
Description of WorkiG� -
Temp Pedestal Yes or No
❑ 150 Amp or Less ❑ 200 Amp ❑ Other
r
-/O
,---Contact Ne meF&'Phone;# of1JOBSITE SUPERVISOR 7 9 6-3
Subcontractor Info
Electrical4e0J1ak41q LIOdY"C Mechanical Plumbing 800))R plum"r
Framer
Solar
Roofing
Other
Concrete
Other
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 Fort Colli s ordi ances and state laws regulating building constructio
Applicant Signature Print Name Phone
Distribution White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE