HomeMy WebLinkAbout615 S LOOMIS AVE - APPLICATIONS - 5/7/2010City of
I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
ort CO_LlI_ns 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
v Pr
CATION NUMBER / APPLICATION DATE
Job Site Address ee l5- �- 6 11 S L L S Unit #
PROPERTY OWNER INFO: (All owner information is required -it is not optiona) Phone # 7 z L 7�
Last name F 1 i`�`,r/t4AN�J First Name �f !� Middle
Street Address - —1 c City �G!-Tt�n� �f t/k L State C Zi
CONTRACTOR INFO:
Comppmyi Name Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #�
Mailing Address Z- N r`7 z0 7�3 City 2 State C D Zip ®S—e
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm] Sq
151 Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
31d Floor Sq Ft
# of Bedrooms # of Full Baths
3/4 Baths
Unfiished Bsmt Sq Ft _
'/2 Baths # of Fireplaces
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
List appropriate option
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: P
Gas P Electric Electric Main Breaker Size (Residential only) 1;9150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ -46;1,�90
Contact Name & Phone # of JOBSITE SUPERVISOR: 15(2(4 0 `L�t"h�z� 4�,,r-) A�) 71.9
Subcontractor Info:
Electrical Elm% FL- F G Mechanical
Framer i�F v*t offing
Concrete
Plumbing 4:ToA- ? J 14
Fireplace
Solar Other Other Other
Applicant: I hereby acknowl have read th application and state that the above information is correct a�;&nd agree to comply with all requirements
contained herein and of Fort Colli antes nd state laws regulating building construction. -7'r1�
Applicant Signature Print Name 'hone
Phone [(J ��(
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE