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HomeMy WebLinkAbout618 S LOOMIS AVE - APPLICATIONS - 8/11/2009BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 www.fcgov.com/building City of Fort Collins BUILDING PERMIT APPLICATION APPLICATION NUMBER V APPLICATION DATED �YUXL� (� I Job Site Address L-. Unit # — - C-1 -- - t� PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Z Z9 ` 2� 7 / Last Name L�ZlS First Name � - Middle Street Address 2 ZV L� te t�;L (:c!)Al2 City �� State Cr9 Zip CD 5 Z�3 • CONTRACTOR INFO: Company Name —7-.= > s� ��Ti Au Contractor p,��tg�rle� [ Q7C) 'Zl P. 3 Lic. Holder NameeZt�� `�`-'' sty of Fort Collins License # V (Pt�""ro Supervisor Cent # p�?4- Mailing Address - LF �% City E c'-o State Zip LEGALINFO: Subdivision/PU Filing # Lot # I Block # Lot Sq Ft. CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft Residential Sq Ft Comml Sq Ft # of Stories Bldg Height # Dwelling Units 1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths /z Baths # of Fireplaces Air Conditioning: Yes No 3. ResCheck w/Blower Door City of Fort Collins Stock Plan # UTILITIES INFO: Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door List appropriate option #s 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) $ /.5 Oy — Description of Work: 11.3 STQ (_k- Z sad Z —e, x 4 L4 S F ,. F&5r- as izz-cs Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical Framer Roofing Mechanical Concrete ©t'i Plumbing Other Applicant: I hereby acknowledge that I hav ad this ap lication and state that the above information is c rrect and agree to comply with all requirements contained herein and City o nances and s ate laws regulating building construction. Applicant Signature I Print a �?(-4.� � -Phone Zl B 330 Distrib t' White - ffice Yellow -Applicant Pink - WWW/St rmwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE