HomeMy WebLinkAbout2120 Nancy Gray Ave - Applications/Single Family New - 04/19/2012COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER I Q O d' 7 pl) APPLICATION DATE
Job Site Address \ACv-\C\I N-4 t?—R\ \t_ _ Unit #
PROPERTY OWNER INFO: (All owner information Is required - it Is not optional) Phone # p
Last name �C'�1 \\ C�>t\\i Name �, ^ Middle
Street Address ity VA L1,��\c�cj State-QZip t r
CONTRACTOR INFO: Company Name 1�1 contractor Phone #
Lic Holder Name �Y\< <LI� ���p�\l0�\ City of Fort Collins License # -� L lc�, Supervisor Carl #,
Mailing Address City State Zip
LEGAL INFO: \
Subdivision/PUD 5\C\ Filing #r;�s Lot �_ Block # Lot Sq Ft lU� _ #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
r
Residential Sq Ft.., Comm'I Sq Ft # of Stories Bldg Height_ # Dwelling Units
1st Floor Sq Ft q\E� 2nd Floor Sq Ft 3'd Floor Sq Ft I Unfiished Bsmt Sq Ft CWS
Finished Bsmt Sq Ft # of Bedrooms y�_ # of Full Baths (R� 3/< Baths Ys 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. Silated Performanc mue Alternative, 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # \CAm List appropriate option #s ar"'�
UTILITIES INFO:
u �I
Water Tap Size Sewer Tap Size —"A Metered: Yes or No Temp. Pedestal es or No
Type of Heat: XGas ❑ Electric Electric Main Breaker Size (Residential only) Xi 50 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR: t_X1C IA 2-CdK-\XCJ7-\ I �-i�" ��S\
Subcontractor Info:
aR-Io�4ss�0��
Electricals ^ � Mechanical 1 Plumbing1
Framer `� ^�,T \ �V Q Roofing ' %oncrete Fireplace
r
Solar Other Other Other \ce..S�\oc-
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 of Fo Coll' s ordinances and state laws regulating building construction.
Applicant Signature Print Name A S�(1n�O\� Phone
Distribution: White — Office Yellow = Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City of updated 1-31-2012
Fort Collins Planning, Development & Transportation Services
Community Development & Neighborhood Services
2012 FORT COLLINS RESIDENTIAL ENERGY CODE COMPLIANCE FORM
FORM 1 - NON -ELECTRIC HEAT (If using elec heat form 3 must be used), use this form,
for sinole family houses, duplex, townhouses, or multi -family up to 3 stories
Permit Number:
Address:
DIRECTIONS: Place a check next to Prescridtive, UA, or SPA indicating the path chosen. An air
tightness Blower Door Test is required and must pass a 4 ACH leakage max.
(A)PRESCRIPTIVE compliance for
BUILDING ENVELOPE.
e, 2009 IRC, section N1102.1; climate zone S.
INSULATION R-VALUE
Wood frame wall insul r-value
R-20 or 13+5ci
Metal frame wall insul r-value
R-13+9ci or R-19+8
Crawl space wall
R-13 or R-10ci
Roof insulation in attic
R-38
Roof rafter insulation
R-30
Walls below grade
R-13 / R-10ci
Wood floor over un-cond
R-30
Slab on grade floor, unheat
R-101 24" DEEP
Windows
U-35
(B)TOTAL UA ALTERNATIVE (ResCheck), 2009 IRC, SECTION N1102.1.3
Submit a passing UA calculation (i.e. ResCheck) using 2009 IRC/IECC. The rating must be submitted at time. of
application and must include address of residence; name of individual completing the rating form; name & version
of software tool (i.e. ResCheck).
(C)SIMULATED PERFORMANCE ALTERNATIVE, 2009 IECC, SECTION 405
An energy rating system must be utilized using approved computer software tool such as the new modified Fort
Collins version of RemRate. A preliminary rating passing the 2009 IECC must be submitted at time of application.
Rating must include Address, Name of individual completing the rating,& Name & version of software tool. Final
rating requires a blower door test. Final passing rating must be submitted for certificate of occupancy.
SIGN:
DATE:
CONTRACTOR: 6C1c`R �U\�C1CS5
PHONE: 8�&
01202J"1%812021-72j):