HomeMy WebLinkAbout351 Osiander St - Applications/Single Family New - 09/20/2011Clt�yof _(C&kI011i1 7 DE�LOPMENT & NEIGHBORHOOD SERVICES
FOI t}Collins 281 N. Coll ge Ave.+ Fort -Collins, CO 80524 a Phone: 970.416-2740
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p �j BuXDIWG PERMIT APPLICATION
APPLICATION NUMBER 'st APPLICATION DATE I I ac-) I 1
Job Site Address I QsI ND61Z_ �)f Unit #
PROPERTYOWNERINFO: (All owner Information Is required - it Is not optional) Phone # % �Jo J - 70 - E-S93
Last name kt_: T!jLL.F 1 LLG First Name Middle
J StreetAddress_ZZa L LSNN?09 ,A.L City Sttate1`Zip n� -A
CONTRACTOR INFO: Company Name P�441 L \Cyti Iveontractor Phone # 170 - r2Z - 752r4
Lic Holder Name V" A IM116?)TZ1O E Q S �jtG �ity of Fort
Collins License # Lob - Supervisor Cert #
Mailing Address I S1 cD City State
Subdivision/PUD 0Q _TVWH N M_�t� Filing # Lot # Block # _�_ Lot Sq Ft5&A49
CONSTRUCTION INFO: Total Building Sq Ft (notInduding basement) //1?3 15 Total Garage Sq Ft _5)_0
Residential Sq Ft S Comm'I Sq Ft # of Stories 'L Bldg Height�Q_ # Dwelling Units I
ld Floor Sq Ft 2n° Floor Sq Ft �a�q 311 Floor Sq Ft Unfiished Bsmt Sq Ft �fJ
Finished Bamt Sq Ft # of Bedrooms # of Full Baths '/.-Baths '/ Baths I— # of Fireplaces
A/rCondltloning. Ye Jo,�nLj Energy Info: ( QrUe appropriate -choice) 1. ComCheck 2. ResCheck w/Air Sealing
S. ResCheck w/Blower Door l 14. Simulated Performance Alternative�5 Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Doofl
City of Fort Collins Stock Plan # List appropriate option #s t./
UTILITIES INFO: / II
Water Tap Size �_ Sewer Tap Size _ Metered: Yes E] o0 Temp. Pedestal YesL No
Type of Heat Gas ❑Electric Electric Main Breaker Size (Residential only) 150 Amp or Less ❑ 200 Amp DOther
Value of Construction (including labor, material & profit) $1
Description of work: �IiJ/itL��T�It.7i 1�%rF61�%����
Contact Name & Phone # of JOBSITE SUPERVISOR:
ElectricalMechanical MQZTN� 60�- big Plumbing
Framer Roofing 'PNZ,TN Concrete PFV7Lr%ISZU_ Fireplace
Solar Other Other -- Other
:,'Applicant: I hereby a dge that 1 h rea&fts a plicatio nd state that the above information is correct and agree to comply with all requirements
corda4led herein and of Collins i stafe.l regulating building construction. 2
Applicant Signatu Print Name Phone
Distribution: White - Office Yellow - Applicant Pink - W W W//Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE