Loading...
HomeMy WebLinkAbout205 W Oak St - Applications/Tenant Finish - 03/01/2012COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES Fort Collins 281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760 www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER �ry (/ V / (DlJ APPLICATION DATE 3 / —/ � Job Site Address o ,j V. oc_- k Unit # y f 6 El PROPERTY OWNER INFO: (All owner information Is required - it is not optional) Phone # Last name —co le t)gC "� First Name /31 1/ Middle Street Address a iD S W' 0� k City F> • co l h `r f State Co zip 0 5 e! CONTRACTOR INFO: Company �Naame tJ T/ f"1 ,lye &D'I ip h S � U Contractor Phone # / 70 - d oZ 5-0 yM Lic Holder Name r�J/ h 11 C ISO � City of Fort Collins License # 1 / / Supervisor Cert # a Mailing Address 7 ©C Jib✓c )l C Fa?r i0r City Fl. Qit •,f State CO zip RO Sa S 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 0 SO '0 # of Stories Bldg Height # Dwelling Units 0 15' Floor Sq Ft Finished Bsmt Sq Ft Air Conditioning: Yes No 2nd Floor Sq Ft 3rd Floor Sq Ft # of Bedrooms # of Full Baths _ _ '/< Baths Energy info: ( Circle appropriate choice ) 1. ComCheck Unfiished Bsmt Sq Ft '/z Baths # of Fireplaces 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing City of Fort Collins Stock Plan # UTILITIES INFO: 6. Prescriptive w/ Blower Door Water Tap Size Sewer Tap Size 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 V Value of Construction (including labor, material & profit) $ r ���� e ,,fiy Pore Description of Work: nNn0 8 t, 'C C �G S , 0 Cc P. r C /V 00 irS (e /, ,IT Contact Name & Phone # of JOBSITE SUPERVISOR: List appropriate option Subcontractor Info: Electrical A I r sc l( � � ecl "' L, Mechanical Framer 5) h A/e r.7' Cony Roofing Concrete Solar Other Other Plumbing Fireplace 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 and City o��Fort Collins, ordinances and state laws regulating building construction. Applicant Signature SlJ;/ Ct'V Print Name Gt/r5 /V/ CbOh Phone Distribution: White —Office Yellow —Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE