HomeMy WebLinkAbout321 Maple St - Applications/Addition or Alteration - 09/20/2012COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
City of
F6rt Collins
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER ) -b55 A q APPLICATION DATE !!j6!24 7-
Job Site Address 32, Unit #
PROPERTY OWNER INFO: (All owner information is required -it is not oLio l) Phone #
Last name / CrLZ PiL�S First Name , �� Middle
Street Address es L.q qyr- 41/'2 . CitState Zip
CONTRACTOR INFO: Company
��Name
((�� e.QQO_ Fc. Contractor Phone # 97t' O—ZZ-6-z73
t Lic Holder Name 99 -- ape-Q.LotC City of Fort Collins License # Supervisor Cert #
Mailing Address x-.� City State
LEGALINFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq Ft_
15' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3rd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/4 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. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option #s
Water Tap Size Sewer Tap Size Metered: Yes or No 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) $ -55Z CO 0
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR: 0)/ n a+— �aZ1.ot�g
Subcontractor Info:
Electrical t:c o-e4o Mechanical
Framer 6C Roofing
Solar
Other
Concrete
Other
Plumbing
Fireplace
Other
C
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 F rt Collins ordinances and state laws regulating building construction.
Applicant Signature J� Print Name Gam/ l4,— Phone 9%4-222-032'%
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLBCATIORI EXPIRES 180 DAYS FROM APPLICATION DATE
City of Planning, Development and Transportation
Fort Collins PO Box 580
281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134fax
Commercial Construction Application Information
Revised 03/30/2009
Application Number:
Job Site Address: 32 ( MADLe._
New Building
Addition
Building owner: Ci'fci oG i o-� cauro-s
Building owner address: 300 Lvo.--fie.- Le.
Building owner phone #: 970- Zzl -�27 3
Name of Business:
Remodel/TF K_
Proposed Use: (i.e. medical, office, bank, retail, etc) Qwln�i
Project square footage: T S �•
For commercial remodels Et tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an (please circle answer)
existing tena or new tenant?
➢ If for a new tenant, is this the first tenant to occupy this space? Yes or No
➢ If not the initial tenant for this unit, what was the previous use of this tenant
Space? -W
➢ Are there any exterior building changed associated with the work? 6 orAz�
If yes, please describe: k& u'L( l a.-�aQ_ o�,. d r.n. OR
Signature of a p icant
Name (please print)
Ny 8?s6
Lam. o. ,
loo. Stotoa, 567020
tll �¢,�(ru eera2i:� i� O
q1/71Z
Date
470-'Z2-7-03 Z9
Local daytime phone #