HomeMy WebLinkAbout210 W Magnolia St - Applications/Tenant Finish - 03/12/2007BUILDING PERMITS & INSPECTIONS DIVISION
p 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 T V / APPLICATION DATE v/� �
Job Site Address Z10 l:/es-y- no//eA Unit # //0
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ri %O - Z Z f-/- 5-3 2 8
Last Name Fit/ ro n First Name S t r G Middle
Street Address IqL16 East IR!i evcat pZ(.City �i. ��///sus State eO Zip �O5-Lc/
CONTRACTOR INFO: Company Name
d� 1' mr/SC-ua oyrSContractor Phone # g %O -
Lic. Holder Name <<cen /G%Claze!te City of Fort Collins License # )3- 370 Supervisor Celt #
Mailing Address 0- e5oK ZOO City , State eO Zip [SO.S.SU
LEGALINFO:
Subdivision/PUD gZ Oc(00/D00 Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) " Y A Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# of Full Baths % Baths /2 Baths # of Fireplaces
Energy info: (circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option
UTILITIES INFO: A//
Water Tap Size Sewer Tap Size Metered: Yes or No
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
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) $ /O 3, 000 - m
a
Description of Work:
u.Y— f,4N G/✓Ii-sue, Go a. CC�iis(r /HG�u.�+g �.�i�L�iA�
Contact Name & Phone # of JOBS ITE SUPERVISOR: Baru -^e- -
Subcontractor Info:
rC
f;
-M
-M
Electrical -14Af,5,t- U ,162P lechanical 41 LOB tO�1' Plumbing PluA,:' 1-7/ir5
Framer A110A Roofing /�rt Concrete /y� 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 Signaturer�/�e- . sz :�ec - Print Name"&)aw Phone ' ] 74-t'y�le ^6300
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE
Community Planning and Environmental Services
Building and Zoning Department
City of Fort Collins
Commercial Construction Application Information
Revised May 10, 2000
Application Number:
Job Site Address: Z10 .Unit # /lO /Zv
New Building Addition Remodei/TF X
Name of Business: 1PTS I�-e62e- fir c'
Proposed Use: (i.e. medical, office, bank, retail, etc) ?h sieft f 7Ae����
Project square footage: 176 J 5
For commercial remodels and tenant finishes, please answer the following:
❑ Is the remodel/tenant finish for an existing tenant or new
tenant? Nee,, T ," ., , t
❑ If for a new
space? t
nt, is this the first tenant to occupy this
❑ 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
work? 'Al0
Describe:
/Signature
I f7/'ruw ��ii G fihs.
Name (Please print)
-3 /2-0 7
Date
6'70 —69-6 — (9 300
Local daytime phone #
281 North College Avenue • PO. Box 580 • Fort Collins, CO 80522-0580 ° (970) 221-6760 • FAX (970) 224-6134