HomeMy WebLinkAbout4965 HOGAN DR - APPLICATIONS - 8/8/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
CHOI 04
Fort Collins
APPLICATION
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION DATE 'i? '
Job Site Address T . %0 6�41,4 PR Ulm Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # 6 26 J u ` /7 Zwl
Last name kt O R TZ (_S First Name rS F54K Middle
Street Address_ CwA( 0'Q City CF_ State ed Zip C'
CONTRACTOR INFO: Company Name
Contractor Phone #
L i c Holder Name of Z-/ FFOA I7 /- , �� City of Fort Collins License # Supervisor Cert #
Mailing Address 3-77 131-uF G-o2i4SS %-- City W/A0S®%Z State �G) Zip A L sad
LEGAL INFO:
Subdivision/PUD Filing # Lot #,
CONSTRUCTION INFO: Total Building Sq Ft (not including
Block # Lot Sq Ft
Total Garage Sq Ft
Residential Sq Ft foci(' Comm] Sq Ft # of Stories / Bldg Height # Dwelling Units
1st Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
3m Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # 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 x(5 ( Sewer Tap Size EX Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: � Gas ❑ Electric Electric Main Breaker Size (Residential only) ;K150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
Description of Work:
Contact Name & P, one # of JOBSITE SUPERVISOR: 0L(FF.QAD `?70 -,;t 1 7 -ii'c;>.33
Subcontractor Info:
Electrical e&QoG, F-6-f K (d / / LG Mechanical dT=- Q t1 n I= Q f f - Plumbing �2e-j A PcyjZl42% F 104 U/ai
Framer461xe5 kAo'm a(-i` �Roofing Concrete (2blt(di'2 L*-t Fireplace e6VA
Solar 41A Other >�/f� Other W114 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 PX/ 4" 411 Print Name /� V� 1� 12 , It-i phone (.2 c
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE