HomeMy WebLinkAbout209 Egyptian Ct - Applications/Basement Finish - 07/13/2018City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort+t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER ` t O's 5,5 —1 APPLICATION DATE 13 I V
Job Site Add
Unit #
U 5 `' 2 C ��
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # / � � ✓� S
Last name c5r'.lil t.✓ J IS First Name lzziA Middle
Street Address ; (,) 1 gj 1 1�71(�,, C4 City ) -7— 44- ✓7S State 6-<-) Zip
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm] Sq
1$1 Floor Sq Ft
2nd Floor Sq Ft
Contractor Phone #
City of Fort Collins License #_
Citv
Supervisor Cert #
State Zip
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
311 Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished"Bsmt Sq Ft # of Bedrooms 0 # of Full Baths 3/4 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 # List appropriate option #s
UTILITIES INFO:
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) $ .eC ooy 1
Description of Work: r-cl 41e Gt r L 9.1[/t"n
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 rt ollins ordinanc s ,, sta laws regulating building construction.
Applicant Signature ` i/f � Print Name 4,i7 5er .✓0 ISPhone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE