HomeMy WebLinkAbout421 Osiander St - Applications/Single Family New - 06/16/2014City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F61 t Collins 281 N. College Ave. •Fort Collins, CO 80524 •Phone: 97016-2740
/ www.fcgov.com/building Pet,
BUILDING PERMIT APPLICATION
APPLICATION NUMBER b I Y ® S I q 8 APPLICATION DATE (0 -1 6 --
Job Site Address �4 ?A US�air1dd_ Unit #
PROPERTY/OWNER INFO: (All owner information is required - it is not optional) Phone # 61 i Q ^ (: 9 - 7 2Z U
Last name l t-.WuCj First Name G` Middle
Street Address � 1��1. 111���� Ci1ty�^\��t��.✓�� C��1� �Sjt'atte/�C�^� Zip��Q
CONTRACTOR INFO: Company Name v�wY 1�\-W� \ I Contractor Phone # l FU ^ (iL� tJ�[��
Lie Holder Name Yjp�umCity of Fort Collins License # Ss' Supervisor Cert #
Mailing Address � Jc2e. �IutL�u +K.i �v..lh City \orL1tC-(1(VU StateM _Zip )�
LEGAL INFO: I
Subdivision/PUDS�_ �,RhE2± Filing*____ Lot #-s-- Block #--D-_ Lot Sq Ft /JU �V
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) )Bon Total Garage Sq Ft qZ "
Residential Sq FtV59,D Comm9 Sq Ft ' 1 � # of Stories Z- Bldg Height # Dwelling Units
I'Floor Sq Ft �� 2"d Floor Sq Ft L� 13 3' Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms - # of Full Baths 2 '/4 Baths '/z Baths -L- # of Fireplaces
Air Conditioning: Y`/L�JN Energy info: ( Circle appropriate choice) 1. ComCheck� 2. ResCheck w/Air Sealing ❑
3. ResCheck w/Blow rt Door 4. Simulated Performance Alternatives. Prescriptive w/Air Sealing❑ 6. Prescriptive w/ Blower Doo�
City of Fort Collins Stock Plan # �3 List approroJJJpri___ate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes�No❑ Temp. Pedestal Ye�No0
Type of He Gas Electric Electric Main Breaker Size (Residents Ib only) 50 Amp or Less ❑ 200 Amp ❑Other
YP Ip (\
Value of C nstruction (including labor, material & profit) $ �1�
Description of Work: 51y� C-yl '0`IT �C� � — SAbQV, n� (�
Contact Name & Phone # of JOBSITE SUPERVISOR: V \A- \ S):ew u� , 9—)Lc-act- QUM
Subcontractor Info:
rA �j
Electrical BI� lQl (L(!L vLR (M�e/cha�nical �r 7 . Plumbing
Framercnycu uob`� Roofing \ 17� C��� (Concrete _�.�Sl. IN Fireplace VA54 lt "911reo
I
Solar
Other
Other
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 of Fort Co ins ordinances and state laws regulating building construction. �� / , _ o —7
Applicant Signature Print Name )LZV�� 1e�" Phone 617b -V _I A
Distribution: White —Office Yellow —Applicant Pink —WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
updated 1-31-2012
Fcie COUMS eilre-15milig, Develop.aili.
r�oriarI Unliy Detrolopmeiit & Neighborhood Services
FORK r �J� f=�� , � 6 GGP (d e� aa� ®� heat he used), use Ohis form
rat
n�a pis
l�®�'iv9ift i4llili+IL4�P: -.
lAddressfZ
a
®IRCa ®6t9Sa lase Sae � nre�:t n'�; a3pi�ii , A, or g-qj isidicaiapg the path chosen. An air
-tightness B1OVV@5' DOOF T eu� is Maui ed caned ralust puss rel 3 ACH ieaka€o, e iVI.M.
cornplaanw, for h*ume, 2009 ERC,- seo*dorg i,i•e 102. , dimate zone S.
ENVELOPE
KNIIS,u@:ff911N PVNIALOE
wood frame wall insul i•--value
- R 20 oi• 7 31-5ci
Metal frame wall insul r-Nralue
l R 13+9ci or R-19-_i_8
Crawl space wail
[-:i 3oi_ lOei
Roof insulation In attic
_
�� R 38 _
Roof raker insulations
Walls below grade
R-30
iZ 13 / R-10ci�
Wood floor over tan-cond
Slab on grade floor, unheai
_ �6y� R-30_ ___
10, 2 DDEEEP
U-35
(E g Ora UA AR TERNKUIVE (ReaChadn'), MOW Inc? S=7 fi�9
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 fine rating form; name & version
of software tool (i.e. ResCheck). -
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
ratina reouires a blower door test. Final passing rating must be submitted for certificate of occupancy.
UU 1 2 9 1 90/, no