HomeMy WebLinkAbout110 E Oak St - Applications/Other - 12/04/2007BUILDING PERMITS & INSPECTIONS DIVISION '::' 2
j �✓ P.O. Box 580 •Fort Collins, CO 80522 0580 • Phone: 221-6760 a all
www.fcgov.com/building
CityofFort Collins BUILDING PERMIT /r�, APPLICATION
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APPLICATION NUMBER Y✓ O r7O 7 J I � APPLICATION DATE' 2 — 1 — b /
Job Site Address o O Oak 51 Unit #
PROPERTY OWNER INFO: (All o�w�ner informaatntion is required — it is not optional) Phone #
Last Name ( 1 (� l�llRK Lt11,/' First Name p I Middle
Street Address _�� l�N `�y �� fit/ ; tt S� w A /0 City I�(�2� l � it 1115 State Zip
CONTRACTOR INFO: Company Name G'i W 6 t'-i Ca ,itya S Contractor Phone # (3
Lic. Holder Name aL va B. City of Fort Collins License # 4 Is-1 Supervisor Cert #
Mailing Address b S s c.LVVIw. ii U e W CitState Co Zip 0 91
LEGAL INFO:
Subdivision/PUD
Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths % Baths /z Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
Water Tap Size Sewer Tap Size
List appropriate option
Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less 11200 Amp []Other
Value of Construction (including labor, material & profit) $ I Qai . ru
Description of Work: `Ayj Vl 'i m a .S -tor- Qa k .s-f R e_rnod ®l N4O`il iex
Contact Name & Phone # of JOBSITE SUPERVISOR: wlG,n •r. I 1 9 70 `�
Subcontractor Info: `�
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Electrical Mechanical P z mbi /
Framer
Roofing
Concrete
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. J
Applicant Signature "C�-L A Print Name C1 V t SR ar Phone
Distribution: White — 4ffice Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE