HomeMy WebLinkAbout4856 Innovation Dr - Applications/Tenant Finish - 01/18/2008BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 �1^,
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER VC) 3 0")u APPLICATION DATE i alb u
Job Site Address Unit # g
PROPERTY OWNER IINF-O: (All owner information is required - it is not optional) Phone # Z2� �ZSO Z--
Last Name �rn/First Name -;?on��++ Middle
Street Address IOZ-7 I�irlrt2�P�I • city ° I4. a I � to � �(Sttattte p��J/ Zip �SZ
CONTRACTOR INFO: Company Name (1•./I��'(�/CJ�Ib/\ Contractor Phone # -7 7 A —O /lop ,Q
Lic. Holder Name ���^(ok& City of FortCollins License # i"1 `l Supervisor Cert # /.i41' 1
Mailing Address ZO�s "2vrP:f e -,P' City --P_ Cni I i' S State Zip ��MZ 1
LEGAL INFO: ,r��
Subdivision/PUD l./r(krI -C Filing # 32 Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished 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. E-Star w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Water Tap Size Sewer Tap Size
5. Prescriptive w/Air Sealing
List appropriate option
Metered: Yes or No
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)
Contact Name & Phone # of JOBSITE SUPERVISOR: IV11rV, kkK-'S-r Qca ( -
Subcontractor Info: C ✓ f
Electrical �A,A AAL t_- kAr�-' Mechanical Plumbing F� S
Framer K)� Roofing QUA Concrete 0 ( A Other rJ!A
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 Colli ordinan nd state laws regulating building construction. ,, ff
Applicant Signature Print Name ��i4 1�I4dStr Phone �,372 "213Z
Distnbu 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: 8080038
Job Site Address: W sl"(O nA o ar �� Unit #
New Build
Addition Remodel/TF,
f
Name of Business:c.��-�2n��c� lLCo ,
Proposed Use: (i.e. medical, office, bank, retail, etc) wee
Project square footage: 33(0
For commercial remodels and tenant finishes, please answer the following:
o Is the remodel/tenant finish for an existing tenant or new
tenant?
❑ If for a new tenant, is this the first tenant to occupy this
space? t J 1,c4
a If not the initial tenant for this unit, what was the previous use of this
tenant space? (If known) ti IA
o Are there an exterior elevation changes associated with the
work?Nr,
Describe: ►jJA
ignature
Name (Please print)
M 174 2ooy
Date
y9 $-Y-X�G
Local daytime phone #
281 North College Avenue 9 P.O. Box 580 1 Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134