HomeMy WebLinkAbout4040 S College Ave - Applications/Addition or Alteration - 03/14/2006BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.conVbuilding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1►/ lU 0 I Oi S 0 APPLICATION DATE
Job Site Address COU,EGC T. Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #
Last Nametb UMCK P�NCI �{fl_ First Name ^ `r Middle
Street Address IM { 2�p 1'�. City , 1G State_Zip
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holder Name
City of Fort Collins License #
Mailing Address City
LEGAL INFO:
Supervisor Cert #
State Zip
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 4q 1 112 Total Garage Sq Ft �'
Residential Sq Ft ` �omm I Sq Ft 2toda # of Stories_ Bldg Height. # Dwelling Units
1st Floor Sq Ft 1� 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms _ # of Full Baths ' — % Baths % 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 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # List appropriate option
UTILITIES INFO:
Water Tap Size ?07T,— Sewer Tap Size r*q'. Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less 11200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 200 FOOD. co
Description of Work: �N l[KR- KnVIDW O� 'RWrv- TUV- t50WZN%W- Ii (TH M AM
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 Col s ordinances and state laws regulating building connsstruu�ctionn..� ,/
Applicant Signature Print Name Il 1�/ VVP Phone WU3.3Z16
Distribut on: White — Office Yellow —Applicant Pink — WWW/Stormwater 330 - "'�54 5 o
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE
03/16/06 THU 1 :39 FAX 216 229 3210 HERSCHMAN ARCHITECTS INC Z 003
MAR-16-2006-THU 02:45 PM P,004
Community Planwng and Environmental Services
Buildi-ng end zoning Deparbnent •
B-0-6 01
of Fort Coll-ns03.0
Commercial Construction Application Information
R6410d May 10, 2000
Application Number..
.lob Site''Address: g • Ave- Unit #
New Building Addition Remodel/TF—lt/-_
Name of Business:. f 7
Proposed Use: (i.e, medieol, office, bank, retail, etc)
Project square footage Zom
For com rcial remodels and tenant finishes, please answer the following:
dIIs the re MIte finish for an existing tenant or new
tenant?
.gyp•' If for a new tenant, is ,this the first, tenant to occupy this
space7..�
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:
Crt
Name (Please print)
Local daytime phone #
1.
281 North CoDege•Avenue - PO, Box 580 • Fort Co1Gns, CO 9052.2-0580 - (970) 221-6760'- FAX (970) 224-6234