HomeMy WebLinkAbout608 KEENESBURG CT - APPLICATIONS - 1/6/2016City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
wwvv fcgov corn/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER _i3, rJ 6 /2C?%j APPLICATION DATE IO
Job Site Address 608 Keen§burg Ct Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 970-988-9866
Last name DeZeeUW First Name Terry Middle_
Street Address 608 Keensburg Ct City. Ft Collins State CO Zip 80525
CONTRACTOR INFO: Company Name
Contractor Phone
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD 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 Stories Bldg Height # Dwelling Units
Is' Floor Sq Ft
2nd Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft 650 # of Bedrooms 1 # of Full Baths .% Baths 1 '% Baths # of Fireplaces
Air Conditioning: Ye flNo0 Energy info: ( Circle appropriate choice ) 1. ComCheck 11 2. ResCheck w/Air Sealing11 .
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative❑ 5. Prescriptive w/Air Sealing S. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes ❑Noo Temp. Pedestal Yes❑ No ❑
Type of Heat. ❑ Gas1-1 Electric Electric Main Breaker Size (Residential only) F-1150 Amp or Less 11 200 Amp 0Other
Value of Construction (including labor, material & profit) $ � :;A I U
Description of Work:
Basement Finish
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer VanderVliet COnSt. Roofing
Solar
Other
Mechanical Tri-City Heating & Air Plumbing
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 Collins ordinances/�and state laws regulating building construction.
Applicant Signature
- / ftc 22/ Print Name Terry DeZeeuw Phone 970-988-9866
Distribution: White -Office Yellow -Applicant Pink -WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE