HomeMy WebLinkAbout426 E OAK ST - APPLICATIONS - 8/31/2015City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Forrt Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 3 60 0 � � _ APPLICATION DATE
Job Site Address 42e0 -a -rr S—r. �R—, + Unit #
PROPERTY OWNER INFO:_ (All owner information is required - it is not optional) Phone # T '
Last name Q.,ea-f- First Namepl- 'L- Middle
Street Address 4-2C=7 4 � flp�`<- S�• City C'°�� P ►YES State C�✓P QZ.i j
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CONTRACTOR INFO: Company Name ib p7' �J p� contractor Phone # �2�Z— !
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Lic Holder Name ! +� � -',I p ! U / City of Fort Co-llin^s�Lice�gnse #p I I Supervisor Cart # B 2/
Mailing Address:51;Z C;1 Cr. City 'ate 1 � Stated • Zip
LEGAL INFO:
Subdivision/PU
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:
2"d Floor Sq Ft
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/ Baths '/z 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: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) S � �%t An4' � g32'�
Description of Work:—,,
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ewe-. C��r"T�bS _ �c—e.�UTsaLV .�IN�`4ao1r��
Contact Name & Phone # of JOBSITE SUPERVISOR: LJ�r-+�rr-:A4.(7,-- clw -22--I-A 1 2Z�
Subcontractor Info:
ElectricalMechanical
Framer i D - Roofing
Solar
Other
Concrete
Other
Fireplace
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 f F olli�ns orddiina` ces and state laws regulating building construction. ^►
Applicant Signatuy�=� Print Nam i Phone /-&��
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE