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HomeMy WebLinkAbout2212 Loyola Ave - Applications/Addition or Alteration - 07/27/2010of City Coltins COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER APPLICATION DATE :?/2-7 It L Job Site Address 2Z(2 L-pvt,4 .,ram Unit # PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # ` 7o 7_1'5 (le, 6 'epo Last name eZ4T u,<' First Name Middle �e Street Address Z.� (/'L td+ 4�t L� City State. � Zip CONTRACTOR INFO: Company Name �CT it✓ Contractor Phone # (YO 2LA 33�C� Lic Holder Name t ity of Fort Collins License # �C�1' Supervisor Cert # Mailing Address l ©'Z�j Jl� �L' �Y 7 City State (,:7) 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 15' Floor Sq Ft 2°d Floor Sq Ft # of Stories Bldg Height 3rd Floor Sq Ft # Dwelling Units Unfiished Bsmt Sq Ft Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % 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 # UTILITIES INFO: 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, material &profit) $ c'c!7' 0 Description of Work: (l���tQ L� 2— Contact Name & Phone # of JOBSITE SUPERVISOR: `�rZlA� 0'0 37VD Subcontractor Info: Electrical Framer Solar Roofing Other Mechanical Concrete Other Plumbing Fireplace Other Applicant: I hereby ac I have re his application and state that the above information is correct and agree to comply with all requirements contained herei d City of Fo awe nd state laws regulating building construction. Applicant Signature Print Name3ZfAPeA—_—, -S Phone ' 1 j Distribution: Whilb—Office Yellow -Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE