HomeMy WebLinkAbout507 N Loomis St - Applications/Addition or Alteration - 01/15/20104
City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
l (}i�/��7j� BUILDING PERMIT APPLICATION
APPLICATION NUMBER A I00D1 i/lp APPLICATION DATE I
Job Site Address
S
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # T,7b • 41,2 00
Last name First Name 6f-11? j�/ I Middle
Street Address ��� �I Le'o vl'7 iS City �l� C-c�( IIhS State C-F Zip
CONTRACTOR INFO: Company Name OLM CCYIs�-r( Contractor Phone # (�3o ' GILD - 2qoZ
Lic Holder Namejl t C C( 'cJ i'L1 L 11 City of Fort Collins License # 'J ✓� ` Supervisor Cert #
Mailing Address Z City �� ��' rf� S State G� zip�L
LEGAL INFO:
Subdivision/PUD F�� Filing # Lot # �` Block # 9.6!57Lot Sq Ft' 0 3v�
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) dD Total Garage Sq Ft'
�r rr
Residential Sq Ft �!��� Comm'I Sq Ft # of Stories_ Bldg Height � #Dwelling Units
161 Floor Sq Ft ` 2:3 d 2nd Floor Sq Ft 160 31d Floor Sq Ft Unfiished Bsmt Sq Ft 9
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths a 1/4 Baths '/2 Baths I # of Fireplaces
Air Conditioning: Yes (Q 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:
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat:" Q Gas ❑ Electric Electric Main Breaker Size (Residential only) `SQ 50 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)/$ % orIU r0 50 �j
Description of Work: �!'�d-,.SFkru C�7 6ry'L ' ��Jt7/T! S el- !/�'/ pis ��C[.(� /7/-
C2e 'oo th 5 tCrt� CL„n� 9,'i"
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: /
Electrical 2"11 ') G Mechanical 9n i��i7/� 'CL,ICl/.S�fPlumbing � c �1z�1 I
Framer t� y Roofing:Dig01'7..C.Lj Concrete ems./ /�— Fireplace \
Solar
Other
Other
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 andC� 'of Fort Collins
C�oll�innss ordinances and state laws regulating building construction.
Applicant Signaturb �t ` a`���� Print NamANTfI/ i9'Pe�7LE12. Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE