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HomeMy WebLinkAbout210 W Magnolia St - Applications/New Commercial - 12/05/2005_r{ BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 WWW fcgoV.conVbuilding City of Fort Collins _ BUILDING PERMIT APPLICATION APPLICATION ,NUMBER APPLICATION DATE Job Site Address o?Jp /'}')Q�.r, p��Q Unit # J y PROPERTY OWNER INFO: dA I owner information is require it is not optiona,O M Phone # �q%d [P / -y e Livia once , t�- AI S , Last Name d A2 First Name &111 Middle Street Address (/ m t.(j Lp✓/-u CityF7nPv/'+- (A ( t C State � Zip 9015 CONTRACTOR INFO: Company Name @Vl _-",0"Lr Contractor Phone #61 R(, `j- 81s4 Lic. Holder Name_ GZCis , n)q/� 22 City of Fort Collins License # f33(cf Supervisor Cert # Mailing Address r/ / la.��cd��>� dvQ(/ �d� 6-3m City itCskAS State l'0 Zip AD LEGAL INFO: Subdivision/PUD_65pTK-Q4 Filing #_ Lot # ._ Block # Io > Lot Sq Ft �.2$O CONSTRUCTION INFO: Total Building Sq Ft (not including basement) G . �6 Total Garage Sq Ft K, 71)6 Residential Sq Ft O Comm'I Sq Ft 3 000 # of Stories_ Bldg Height # Dwelling Units 18t Floor Sq Ft 111ID1,00 2nd Floor Sq Ft / 0,22-0 Unfinished Bsmt Sq Ft----P Finished Bsmt Sq Ft d © 0 # Qfedrooms # of Full Baths �Cr3 s/. Baths Y Baths 3 # of Fireplaces V) v'V 3 uUI - IoSlepor- 1`fr. V,o� —._— _ Air Conditioning: o Ene y 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 Sealin 6. Prescriptive w/Blower Door City of Fort Collins Stock Plan # List appropriate option #s UTILITIES INFO: 11 �- Water Tap Size Sewer Tap Size Metered: Yes r No Temp. Pedestal: Yes or No 2 Type of Heat: 1 Gas ❑ Electric Electric Main Breaker Size (Residential only): 0/150 Amp or Less ❑ 200 Amp ❑ Other Value of Construction (including labor, material & profit) $ 5� 0 v G Description of Work: Contact Name & Phone # of JOBSITE SUPERVISOR: _Y4-un 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. p Applicant Signature W Print Name 5?YOIQ Phone 7 / Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DA ( - D I o I I Fax a Community Planning and Environmental Services t�ity of dart co7uns Building and Zoning Department Commercial Construction Application Information Revised May 10, 2000 Application Number: Job Site W it # New Building---), Addition Remodel/TF Name of Business: Wi Proposed Use: (i.e. medical, office, bank, retail, etc) Project square footage: -'/0 , fj -0 S-P For commercial remodels and tenant finishes, please answer the following: ❑ 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? ❑ If not the initial tenant for this unit, what was the previous use of this tenant space? (If known) ❑ Are there any exterior elevation changes associated with the work? Describe: Signature Name (Please print) Date (-?7o�a�9s� Local daytime phone # 281 North College Avenue • P.O. Box 580 • Fort Collins CO 80522-0580 • (970)221-6760 • FAX (970)224-6134