HomeMy WebLinkAbout621 ROOK ST - APPLICATIONS - 12/30/2011 (2)City of
I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t CottinS 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER �)Il 11 4A--) APPLICATION DATE `0%b 1 k
Job Site Address 6a?/ / ooe 5711,.e,704 Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #_ 7`7re-rd Q
Last name /' A1*',0zjr1& /Z;Pr4l GLC First Name Middle
Street Address 273�'�arc City t Ga��itf' SSttate,/"ZZiipFoup;z
INFO: C CONTRACTOR INompa/nny�Na ✓+me Ao DID y)Lj/ Contractor Phone # 79rarz�d
Lic Holder Name r� SS /�/GI r/%// City of Fort CollinsinLicense # e.2 6'7 Supervisor Certrt#�-jr1r-eez
Mailing Address 4���� �Sfic fat y> City GO1/)T State Zip a67
LEGAL INFO: �% ��_ ti
Subdivision/PUD emleel V,140/ Filing # Lot Block # Lot Sq Ft ;23177
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) /!15.2 Total Garage Sq Ft �0O
Residential Sq Ft 5-� Comm'I Sq Ft # of Stories Bldg Height 1-5� # Dwelling Units t/
15' Floor Sq Ft 1/?5.2 2n1 Floor Sq Ft 3'd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft O # of Bedrooms # of Full Baths 1 3/4 Baths _ '/z Baths # of Fireplaces
Air Conditioning: Yes <Do Energy info:( Circle appropriate choice) 1. ComCheck ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative S. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size 3/—( Sewer Tap Size / Metered: Yes or No Temp. Pedest4sr No
Type of Heat: TGas ❑ Electric Electric Main Breaker
jSize
e((Residential only)p,�50 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ -,Aj�S o (t�274f
Description of Work: lad �h:74 ��t r i"H47
Contact Name & Phone # of JOBSITE SUPERVISOR: CV' "vo
Subcontractor Info: o /% / /
Electrical L���� Mechanical Ni�("/YA- /� Plumbing N�°e-eW®�
Framer q Roofing %O9,y Concrete 1144/G140 Fireplace
Solar
Other
Other
Other
Applicant: I hereby acknowledge that I 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 grii6nances and state laws regulating building construction.
Applicant Signature /�� Print Name , \ (/Vvf/Yl { Phone
Distribution: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
11 _ _
Clty of
1 497
updated 1 1 2017
Fort Collins Planning, Development & Transportation Services
Community Development & Neighborhood Services
2012 FORT COLLINS RESIDENTIAL ENERGY CODE COMPLIANCE FORM
FORM 1 - NON -ELECTRIC HEAT (If using elec heat form 3 must be used), use this
form for single family houses, duplex, townhouses, or multi -family up to 3
stories
Permit Number:
kddress•
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 sealina or Blower Door Test.
(A)PRESCRIPTIVE compliant
BUILDING ENVELOPE
Wood frame wall insul r-value
Metal frame wall insul r-value
Crawl space wall
Roof insulation in attic
Roof rafter insulation
Walls below grade
Wood floor over un-cond
Slab on grade floor, unheat
Windows
for house, 2009 IRC, section N1102.1, climate zone 5.
INSULATION R-VALUE
R-20 or 13+5ci
` R-13+9ci or R-19+8
R'-13 or R-10ci
.R-3 3
R-30 . .
R-13 / R=10ci
R-30
.11-10, 24" DEEP .
U-.35
(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 Sealing Checklist or Blower Door Test is re
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 rating must be submitted for certificate of occupancy.
SIGN:
DATE:
CONTRACTOR: i1ci/i//v1 (��
PHONE: 4!And p