HomeMy WebLinkAbout4333 Corbett Dr - Applications/Tenant Finish - 09/28/2007BUILDING 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
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APPLICATION NUMBER O L `� uGlJ6V APPLICATION DATE -! r u 09
Job Site Address y Unit #
PROPERTY OWNER INFO:
�� �(All
vowner information iss required
� ittiis not
optional) Phone #
Last Name t-b�dol- 2�nY"�-t �.orT�� i�lv x�% L-L-E� Middle
Street Address �2214, [t,,Aj6W1 j /�.�qC,, City gte�r M-994714 State /IZ Zip 5�
CONTRACTOR INFO: Company Name 10W ( krr-96-70.�O-)4kaalractor Phone #
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Lic. Holder Name t%�K��l/6 �,- 5G City of Fort Collins Liiccennse" #� 463%4- Supervisor Cert #
Mailing AddressC2 Y �2i7iN�L %�� City �?r C�PJ[ c (AJS State_ Zip
LEGALINFO: �a�t�� 1 /
Subdivision/PUD //RrR*t{�� VlLLt16 Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) � d63 (i-
Total Garage Sq Ft A)
Residential Sq Ft '� Comm] Sq Ft 5 � 4� - # of Stories Bldg Height r rt # Dwelling Units AW
1st Floor Sq Ft d0f D,5 � 2nd Floor Sq Ft rat A Unfinished Bsmt Sq Ft AjA Finished Bsmt Sq Ft
AIA-
# of Bedrooms A f+ # of Full Baths '/< 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. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
City of Fort Collins Stock Plan # AllA List appropriate option #s
6. Prescriptive w/Blower Door
UTILITIES INFO:
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Water Tap Size f— r Sewer Tap Size te;:p Metere es or No Temp. Pedestal: Yes or
Type of Heat: ' ; as ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ -0.7cflj C40
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: /� /) ///1 2
Electrical /X ° Mechanical AR t 'O F'044 — /► Plumbing OYZ
Framer Roofing oee� Concrete C= C!5::r 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 her ' nd-8it Fort i Qrainances and state laws regulating buildiconstruction. A
Applica Print Name �aN > CD11�ktDtA1&-) Phone
Distribution: White - Office Yellow - Applicant Pink - W WW/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: 66,20&r-r Unit #
New Building < Addition Remodel/TF X
Name of Business: �7�tPc_r=S
Proposed Use: (i.e. medical, office, bank, retail, etc) eL--31jf(L-
Project square footage: ob, 04�4
For commercial remodels and tenant finishes, please answer the following:
o Is the remodel/tenant finish for an existing tenant or new
tenant? ---y4c c�
❑ If for a new tena
space?
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)
a Are there any exterior elevation changes associated with the
work? A/0
Describe:
•�►� _
Signature
�-UN Lb S -3�L4�
Name (Please print)
Date
Local daytime phone #
281 North College Avenue • P.O. Box 380 • Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134