HomeMy WebLinkAbout627 S Loomis Ave - Applications/Addition or Alteration - 06/25/2018City of COMMUNITY DEVELOPMENT 8r NEIGHBORHOOD SERVICES
_.,.Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER ✓ 1 WL APPLICATION DATE (G , a ';
Job Site Address627 S Loomis Unit #
PROPERTY OWNER INFO: (All owner information is required — It Is not optional) Phone #
Last name o u l ; First Name 1 11 rl"— Middle
Street Address 410 &Iw Or S I City Fart Co MQ t State_Cg Zip >70 T
CONTRACTOR INFO: Company Name Site Industries/ Basement Escape Contractor Phone #970-227-0789
Lic Holder Name Brian Stephenson City of Fort Collins License # 815 Supervisor Cert #
Mailing Address 519 N Overland Trail CityFC State CO Zip80521
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 # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft b 1 3 2nd Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms 3 # of Full Baths 1 3/. Baths I Y: Baths # of Fireplaces
Air Conditioning: Ye�]Non Energy info: ( Circle appropriate choice) 1. ComCheck1:1 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative❑ 6. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes F-1No❑ Temp. Pedestal Yes❑ No ❑
Type of Heat: a Gas 141Electric Electric Main Breaker Size (Residential only) E1150 Amp or Less 11 200 Amp Other
Value of Construction (including labor, material 8 profit) $ (:�,15W• &0
Description of Work:
Install 1 32"x4Basement egress window per IRC code and engineering
Contact Name 8 Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
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 of Fort Collins ordinances and state laws regulating building c//oo�n1struction. (� { (,
Applicant Signature Print Name 1 �l. n C 1 1r �� L• 1 Phone 1— f i (+ q I �j�
Di ribution: White —Office Yellow —Applicant Pink — VWVW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
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