HomeMy WebLinkAbout404 E Oak St - Applications/Addition or Alteration - 01/12/2012COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER LJ / r2t2O 17 APPLICATION DATE / ���✓��
Job Site Add
Unit $L BfiSN✓NNL1t.f
PROPERTY OWNER INFO: (All owner information is required- it is not optional) Phone # 'd p.5 -- ;7 ti R - S y27
Last name L t1I+1 Nr'2 G First Name �q V 1 / Middle )V�
Street Address -f O 4 �Q (< i' Cityy ' �O:T up 11"1S (Sttater° 0 Zip -?05
CONTRACTOR INFO: Company Name I"tr '"}'lh,y,vn �� , .�a-U Contractor Phone #
Lic Holder Name. t U) City of Fort Collins License #� Supervisor Cert #
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Mailing Address e���`^" o!� City �•,� (U %lp,� State Ck) Zip
LEGAL INFO:
Filing # Lot #I_ Block #_L��J_ Lot Sq Ft_ /0. ZbO
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
# of Stories Bldg Height # Dwelling Units
1" Floor Sq Ft 9 oc) 2nd Floor Sq Ft 3r0 Floor Sq Ft
Finished Bsmt Sq Ft ,J 50 _ # of Bedrooms -o—r[/ # of Full Baths _V % Baths
Unfished Bsmt Sq Ft
'/2 Baths # of Fireplaces _Q_
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
Type of Heat: ❑ Gas U Electric
V lue,"of'Construction includingI boi
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Description of Work: f v 'S p
CD961%!'l_ r� iYr1 (mod'/1�Y/d Yl `FO / r
Contact IYacI & PI one # of JOBSITE SU
Subcontractor Info
List appropriate option #s ka
Metered: Yes or No Temp. Pedestal Yes or No f`(
Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other V
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Electrical) sc,14.teit C-(eC rV'i C: Mechanical Rdkvt IV'n[ot"'i Plumbing �14[I I'
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Framer i""t� SO,✓1 Roofing /,A Concrete b i ll rA10K S 0V.54a•hFireplace )kj /11
Solar to �A Other Other Other
Applicant: I hereby acknowledge tit a have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of rC� s ordinances and s to laws regulating building construction. /� q 1) h
Applicant Signature Print Name CH (ZISTi IL[CC K. N l0L I N Phone `1 -�`� 1 - 7 J7 J
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THUS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE