HomeMy WebLinkAbout809 ROMA VALLEY DR - APPLICATIONS - 1/18/2013City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
/ www fcgov com/building
BUILDING PERMIT APPLICATION�`�' �-7
APPLICATION NUMBER` N �I '-5 APPLICATION DATE ( . 1
Job Site Address
Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # '''I 7Q " / / 7 `?'/ ✓
Last name ANM Ef, First Name*y1_Ul "+ Ci- Flecu►l-a i Middle /?
Street Address 40t9 Qnlvn VA I �•Pw-f DIU i� City r; Lr LD j� , •J S State lQD Zip�05Z4
CONTRACTOR INFO: Company Name
Lic Holder Name
Mailing Address
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
LEGAL INFO: I
Subdivision/PUDIMI(Atylorvl- VA41` 4 Filing #,
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)_
State Zip
Lot # Ad Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft Comm9 Sq Ft # of Stories Bldg Height - # Dwelling Units
151 Floor Sq Ft
21 Floor Sq Ft
3i° Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/. Baths '/ Baths I # of Fireplaces
Air Conditioning: YerJoo Energy info:( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative❑ 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes Nor Temp. Pedestal Yes❑ No
Type of Heat: ❑ Gas r Electric Electric Main Breaker Size (Residential
(,Residential only) �150 Amp or Less ❑ 200 Amp Other
Value of Construction (including labor, material & profit) $ 0 (U �(� t
17
Description of Work: fit G1 X fir 't M IJ � M ov I, f I), D, Tim Sl C) T D u 7
Contact Name & Phone # of JOBSITE SUPERVISOR: 4y i ,,j 7,.l."e—
Subcontractor Info:i Tn/� p
Electrical XS EAge:fQ e-- Mechanical .�--•'t' l � %� Plumbing mml( uv\Rg4
Framer RAMi � Roofing �' ICIK L>A)-. 7- Concrete Akno k (DA:15r Fireplace
Solar
Other
Other
Other
Applicant I hereby acknowledge that 1 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 construction. —� n .
Applicant Signature C "�� rI ICY Print NameT a�1� / �K r> &t� Phone —/ 7d ' Y T r
Distribution: White —Office Yellow —Applicant Pink — WWW/Stonnwater W
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City of
Flirt Collins
updated 11-10-2011
Planning, Development & Transportation Services
Community Development & Neighborhood Services
2012 FORT COLLINS RESIDENTL4L ENERGY CODE COMPLIANCE FORM
FORM 1 - NON -ELECTRIC HEAT (If using elec heat form 3 must he used), use this
form for single family houses, duplex, townhouses, or multi -family up to 3
stories. _ =M � r% *% " i X
Number:
DIRECTIONS: Place a check next to Prescriptive, UA, or SPA indicating the path Chosen. Next, circle the
method within that path you intend to follow. If choosing prescriptive or UA, the applicant must also
choose between Air sealing or Blower Door Test.
(A)PRESCRIPTIVE compliance for house, 2009 IRC, section N1102.1, climate zone 5.
BUILDING ENVELOPE
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
n
I I(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). Air Sealinq Checklist or Blower Door Test is required.
Circle one for either method above: Air Sealing(visual inspection) Blower Door Test
(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 ratinq must be submitted for certificate of occupancy.
SIGN:
C-- / a-r--+2 4c--j
DATE: D
CONTRACTOR:
PHONE: