HomeMy WebLinkAbout4965 HOGAN DR - APPLICATIONS - 9/23/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgovcom/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER � 1 v� :�/ ✓ APPLICATION DATE I / �' KJ
Job Site Address If96�£4fCc:-e¢r4 onju& Unit#
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # 720 — a i 2 — 1376
Last name hAaRftls First Name %5 F At4 Middle
Street Address al cme 5- ya c A a 17k Cit Er. 06 z t/gj,S State CID zip 8 6 g g
CONTRACTOR INFO: Company Name JbAleS #�—Aao 17-= eL49m Contractor Phone # 1? 76 -2cy_:Z- _3a
Lic Holder Name ("[,1IEE(.t EyWr City of Fort Collins License # Supervisor Cert #
Mailing Address / 77 $L O ESSA ass all City &a ,e4 me,, 2 State d'] zip
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including
Total Garage Sq Ft
Residential Sq Ft Comm'[ Sq Ft # of Stories Bldg Height # Dwelling Units
15' Floor Sq Ft 20 2od Floor Sq Ft _
Finished Bsmt Sq Ft # of Bedrooms
V Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Full Baths 3/ Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option #s
Water Tap Size F�(.c�T Sewer Tap Size ;mac t .S r: Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only) �150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)
Description of Work: R(7VFY.L!$F 13A5ntl=K-t SZA rRA -' AF—PTOU A7-4Wr_- L-3,qs.LR
2IEmOui= 10A-tiL P AIuie4G /20aArl/s� r�7s r /�C]Id-KF1r"i27rcLG�
Contact Name & Phone # of JOBSITE SUPERVISOR: /' L, i. F=F1 j> 14, ,F,eAW7
Subcontractor Info:
Electrical N�4 Mechanical cee_ - r-Ieiv`'': Plumbing IM C-_0P__fdF_&_
T c�r
Framer,jo�+tF_S F� ,ZM15 60oofiing r� Concrete 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 ordinances and state laws regulating building construction.
Applicant Signature Print Name 0 L t E (=— AQD � 9AARPone g76 —,q17 9'/ 33
Distribution: White —Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE