HomeMy WebLinkAbout1024 Centre Ave E - Applications/Tenant Finish - 10/30/2007BUILDING PERMITS & INSPECTIONS DIVISION —V '_1�
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 www.fcgov.com/building V ► Vo,
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER � ) 1�r� APPLICATION DATE lot, Ko
Job Site Address 1014 e,
Unit # 100,,
PROPERTY OWNER INFO:: (All owner information is required - it is not optional) Phone #
Last Name 91 SS 4, 1' / First Name Middle
Street Address Lac) ' . eo Y�Z �. —city it-7�j State zip��
CONTRACTOR INFO: Company Name A.& ontractor Phone # iQ - 6 7 ` o-*
Lic. Holder Name QQ City of Fort Collins License # C— Z Supervisor Cert #
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Mailing Address O � �� O�dL p City �/ 6J" iu State � Zip
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm] 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 #
UTILITIES INFO:
2"d Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths s/< Baths /z Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s.
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) $ L6000,y0
Description
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Mechanical
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 Print Name Phone
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
070741?
Job Site Address: /0s� Li C� A- C G,-E Unit # /cd B
New Building Addition Remodel/TFX
Name of Business:
Proposed Use: (i.e. medical, office, bank, retail, etc) &14�Jua.j
Project square footage: 103
For commercial remodels and tenant finishes, please answer the following:
❑ Is the remodel/tenant finish for an existing tenant or new
tenant? N&AA--1
❑ If for a new tenant, is this the first
space? �i''-� — MZ4tY.i,*,
nt to occuov this
o If not the initial tenant for this unit, what was the previous use of this
tenant space? (If known) OLL 4)g c,
❑ Are there any exterior elevation changes associated with the
work? IVU-
Describe:
Signature
t,[6,.+ Qo'� Ram
Name (Please print)
6 C'J— v7
Date
Local daytime phone #
231 North College Avenue P.O. Box 580 , Fort Collins, CO 80522-0580 • (970) 221-6760 . FAX (970) 224-6134