HomeMy WebLinkAbout616 W OAK ST - APPLICATIONS - 3/10/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
Job Site Address &"/4� /,a, .ze, 's�' Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # �;L �� ✓ —'2-1��
Last name /4�%,� First Name P6217(91- Middle c�zaz/ _.s
Street Address City State Zip
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name / City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO: Subdivision/PUD Ol� 70-WA.) 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
15t Floor Sq Ft 2nd Floor Sq Ft 31d Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/ Baths '/2 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: M`
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Water Tap Size W14- Sewer Tap Size IV 1A Metered: Yes or No Temp. Pedestal Yes or No Q
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)J$� J c� '�� /��
Description of Work: Gt Z � ✓!� e,-/ij! Yf` �
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Contact Name & Phone # of JOBSITE SUPERVISOR: a v
Subcontractor Info:
Electrical amp 67'm tye!` Mechanical �ft¢ Plumbing /1 /4
Framer, c�u�.vel` Roofing JTrJNdWeU�/`' Concrete /YD�vsw�G�LUNPJ` Fireplace J
Solar A11A Other Other Other
Applicant: I her by acknowl ge th I have read this a plica ' n and state that the above information is correct and agree to comply with all requirements
contained herein an_d City f Fort Ilins ordinances st laws regulating building construction.
Applicant Signature Print Name A, if-' ►/�C Phone .5;2-7/3,7
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Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE