HomeMy WebLinkAbout939 W OAK ST - APPLICATIONS - 6/26/2007 (2)h
City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER O 7( 1-1 APPLICATION DATE �O ,a c -(DI
Job Site Address C� q W • b 60C -S-k-. Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 310 4P 4- $ 3
Last Name ku1en's K. 4, First Name A I Middle
Street Address �r2:53 6s[.tah-3(,a
t Imo__- O r-, BIM
F&r+ c,1/I �1 �S State eo Zip
CONTRACTOR INFO: Company Name i s (Y.Y15 f` I BIM _ I rC Contractor Phone #
Lic. Holder Name A � 1 L It_Vj,S< t City of Fort Collins License #C c (5_ Supervisor Cert #
Mailing Address 3533 N�-Ih-Pre, D r, City FC State (XI Zip 8OS7-+
LEGALINFO:
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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
2nd Floor Sq Ft Unfinished Bsmt Sq Ft
Finished Bsmt Sq Ft 3&;�
# of Bedrooms
# of Full Baths 3/4 Baths /z 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. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
6. Prescriptive w/Blower Door
a J
City of Fort Collins Stock Plan #
List appropriate option #s
11
UTILITIES INFO:
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
Value of Construction (including labor, material & profit) $ 1 r 00 r`��� . �► `�
Description of Work: 3$ 2. S F' B PAS F M E N T F I N N 1 S W-
Cpynsi s-Fin J o.: TV Room. Bedroom 4- 3 /�. g LX�
Contact Name & Phone # of JOBSITE SUPERVISOR: �I _K h1 L2Y15IC\ 3 O - rG 4 Cj
Subcontractor Info:
✓ V
Electrical E I L Mechanical Alt !QCe6 S o n Plumbing w wy) b to 9
Framer Roofing Concrete 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 d'inancesAand state laws regulating building construction. Applicant Signature% t��w ,GAG Print Name�KU I e_n SK2I Phone 7 I0 6 t53
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE