HomeMy WebLinkAbout1234 W Prospect Rd - Applications/Change of Use - 05/17/2006t , BUILDING 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
APPLICATION NUMBER APPLICATION DATE
Job Site Address /, , #OA4U�Cl 113C Unit #
PROPERTY OWNER
� INFO: (All owner information is required - it is not optional) Phone # 472 —S /(pp
C_._
Last Name aAkA-) - First Name 41� Middle Ie- -
Street Address /36e � ,A-) City 04t&X4 State W Zip 8=(/
CONTRACTOR INFO: Company Name i(1Q2-P 2,kou fin lt&M Contractor Phone #
Lic. Holder Name / /ALLy �� City of Fort Collins License # 6'/2 5 Supervisor Cert # 1:45&
Mailing Address .3 /09 3,Sjqff AU-0V IEV • CitState _ Zip 8o52-�o
LEGAL INFO: Jf
Subdivision/PUD ail Filing # Lot # �)
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) /ys
Residential Sq Ft Comm] Sq Ft /051
1 st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes 'L9'
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Block # Lot Sq Ft�9
Total Garage Sq Ft
# of Stories / Bldg Height /4P # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths % Baths '/2 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
List appropriate option
6. Prescriptive w/Blower Door V�
T
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: 1 Was ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 7500•60
r
Description of Work: ` ,�,d AgAgv an conae p 1�� s
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical _�%�� Mechanical _ l� Plumbing t4 / /1
Framer
C 7 ��� Roofing on Crete' Other L19.1
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
o1rdinances and state laws regulating building construction. /
Applicant Signatureo)wo 1N V Print Name /kl .5 �GSS S Phone Z 2— —09340
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE
City of Fort Collins
Community Planning and Environmental Services
Building and Zoning B0602317
Commercial Construction
Application Informa-tion
Application Number:
Job Site Address: /Z. 3-V
Name of Business: Unit number
Proposed Use: (medical office, bank, retail, etc) c-k
Square footage: 1051 ' .
For commercial remodels and tenant finishes please answer the following:
1. Is the remodel/tenant finish work. for an existing tenant or a new tenant?
2 If for a new tenant, is this the first tenant to occupy this space?
3,. If not the, initial tenant for this unit; what was the prev-------------------
ious use of this
tenant space? (If known.)
4. Are there any exterior elevation changes associated with the work? Describe:
__ I&/W
STgnature Date
Name - Please Print Phone (local #) --
281 North College Avenue • P.O. Box 580 � Fort Collins, CO 80522-0580 • (970) 221-6760