HomeMy WebLinkAbout105 W Mountain Ave - Applications/Tenant Finish - 11/22/2006BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER V! v J ZI� APPLICATION DATE
Job Site Address /0 %[iwt 7toj-Ave, Unit #
PROPERTY OWN15rR INFO: (All owner information is required - it is not optional) Phone #
Last Name AG / . /;/CFirst Name rr Middle
Street Address Llo �i� / ✓`� �� b T �iD.Sz S— r: City 2>> L,✓lI//�15 _ ` State G'(�Zip
CONTRACTOR INFO: Company Name S ��rwaoU C/i 7� �Nc Contractor Phone # T C%�/
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Lic. Holder Name /H i r a City of Fort Collins License # 0 2 Supervisor Cert # �1
Z - Mailing Address V6 4,Le- , City . � , CD��NJ State �'C7 Zip
LEGAL INFO:
Subdivision/PUD
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 /D g g # of Stories Bldg Height
# Dwelling Units
list Floor Sq Ft
2nd Floor Sq Ft Unfinished 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
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3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
6. Prescriptive w/Blower Door
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City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
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) $ /15-,00d,t17
Description of Work:,
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical �! Mechanical / 1//L� Plumbing
Framer / Roofing Concrete 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 �v/� Print Name Phone�71 /C�v7
Distribution: White - Office Yellow -Applicant P nk - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE
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Commercial Construction Application Information
Revised May 10, 2000
Application Number:
Job Site Address: �/%`� 0 A✓euLnit #
New Building Addition Remodel/Tl`
Name of Business T>c�l�lE+�,�„ L-r~7✓�^_,i/c.��
Proposed Use: (i.e. medical, office, bank, retail, etc)��l
Project square footage: /e� 6'-v
For commercial remodels and tenant finishes, please answer the following:
..u� Is the remodeWtenant finish f _ an existing tenant or new
tenant? YZI
❑ If for a new tenant is the first tenant to occupy this
space?
❑ If not the initial tenant for this unit what was the previous use of this
tenant space? (If known)
o Are there any exterior elevation changes associated with the
J/ J/
work? 1vr,alte h6)s
Describe: on i.N Oe;r,�,,,)G,
Signa Date
JD
Name (Please print) Local daytime phone #
281 North College Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134