HomeMy WebLinkAbout210 N Loomis Ave - Applications/Patio Cover Or Sun Shade - 01/30/2008City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
WWW.fcgov.com/building
BUILDING PERMIT APPLICATION 4.9, ', q 3
APPLICATION NUMBER 0 O u O : t APPLICATION DATE
Job Site Address
'.s %!ve-
Unit #
PROPERTY INFO:
(All owner information is required - it is not Phone #
OWNER
Last Name z-
optional)
First Name J
Middle
Street Address
IV- Lot) -'VI ,
S 1 lve.
City / / - s c u, S
State Ct] Zip�3
CONTRACTOR INFO: Company Name J--
E- L� �-a�n5�f"'c Contractor Phone #
7
Lic. Holder Name eL(k
/e.�'
Citv of Fort Collins License #
Supervisor Cert #
Mailing Address /0-5 22 1 o 1� - lr1 L-4 AIL City W� (� n �✓I State e 7 Zip- &GP' 7
LEGAL INFO:
Subdivision/PUD
Filing # ^ Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 1yf //A- Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
# of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths % Baths /2 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 ❑ 200 Amp ❑ Other
Value of Construction (including labor, mat rial & profit) $ I �y ' Lj V
i n q
Description of Work: �/'C' �S ✓t %,� A � 30 � Ani o /4
Contact Name & Phone # of JOBSITE SUPERVISOR:Er r L .S [Mart / 70 713 0-- /'7 55,
Subcontractor Info: N Abr
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
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 Collinsrdinances/nd state laws regulating building construction.
Applicant Signature /�s ��W/ Print Name �� G eie / �, J.— hone
Di§tribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE