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HomeMy WebLinkAbout615 S LOOMIS AVE - APPLICATIONS - 3/12/2013City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 / www.fcgov.com/building j BUILDING PERMIT APPLICATION APPLICATION NUMBER / / / APPLICATION DATE 3 Job Site Address 0 A-D %2 LCeo?,V t is' Unit # PROPERTY OWNER INFO: (All owner information is required - it is not opt' al) Phone # 720 [ 8C) e— r 1 2- Last nameAlFrA;7:=0K .Aj First Name � J Middle Street Address t C W City Cs l 4C— State�ZipB�> CONTRACTOR INFO: Company Name �' .,-f Contractor Phone # 7D z L� �_3*7C---, Lic Holder Name�� City of Fort Collins License #�j6upervisor Cert# 6�_ '7'5��-/ Mailing Address � © Z-� � �`'� z�-% City �C-- State Cy Zip 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 Comm1 Sq Ft # of Stories Bldg Height # Dwelling Units 1s' Floor Sq Ft 2nd Floor Sq Ft 3'd Floor Sq Ft Unfiished Bsmt Sq Ft Finished Bsmt Sq Ft Z # 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. Simulated Performance Alternative 5. 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 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) $ 12- (i ✓ !i , C -LZ0 Descripiof Work:L t�b4 =—=w�tO� A .e— Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical�'r � lJ C:�LP;kt—Mechanical Framer Solar Roofing Other Concrete Other 1-8- Plumbing�S-- f c9ti,17- wa47Z_ Fireplace Other Applicant: I hereby acknowledg hat I have read his application and state that the above information is correct and agree to comply with all requirements contained herein and Cit I.' s ordina as and state laws regulating building construction. Applicant Si ture Print Name Phone ZZ1`_t'o on: White — Office Yellow — Applicant Pink — WWW/Stormwater THUS APPLOCATOON [EXPIRES 180 DAYS FROM APPLOCATUOIR9 DATE