HomeMy WebLinkAbout3665 John F Kennedy Pkwy - Applications/Tenant Finish - 11/27/2013City of
I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Flirt Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER �� 3Z21a25(O APPLICATION DATE / .12� ll3
Job Site Address a Unit
PROPERTY OWNER INFO: (All owner information is required- it is not optional) Phone #
Last name f-T L" I o:5 jA�4Z4 L �C First Name Middle
Street Address , l4,e1/fY-1non7L/fir. alp/ City vi �D��•h_S State eD Zip O, S
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name
City of Fort Collins License # Supervisor Cert #
Mailing Address City State
LEGAL INFO: [[
Subdivision/PUD S�-Cd an Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) J 7 y7(o Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories 3 Bldg Height # Dwelling Units
1 r Floor Sq Ft
2n0 Floor Sq Ft
3r1 Floor Sq Ft/0, // D Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/, Baths 1/ Baths # of Fireplaces
Air Conditioning: Ye5ONon Energy info:( Circle appropriate choice) 1.ComCheck11 2. ResCheck w/Air Sealing ❑
3. ResCheck w/Blower Door ❑4. Simulated Performance Alternative❑ 5. Prescriptive w/Air Sealing 11 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan Al
UTILITIES INFO:
List appropriate option
Water Tap Size{ Sewer Tap Size �_ Metered: Yes 14No� Temp. Pedestal Yes❑ No
Type of Heat: I X t Gas Electric Electric Main Breaker Size (Residential only) 0150 Amp or Less 200 Amp ❑Other
Value of Construction (including labor, material & profit) $ 00 U
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical `7-13 n Mechanical -7-3-D
Framer r/-8p Roofing
Solar
Other
Concrete
Other
Plumbing / /3
Fireplace
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 rdinances and state laws regulating building construction.. r?r!D
Applicant Signature_/j Print Name Vt (16r :,;/) rw2g pi Phone F,?-,'3aa
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THOS APPLICATOOM EXPOO8ES 180 DAYS IFOBOM APPLOCATION DATE
Fort Collins
Commercial
Planning, Development and Transportation
PO Box 580
281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134fax
Construction Application Information
m / in /,)nrio
Application Number: `-
Job Site Address:
New Building
Addition
0
Building owner: �>�. C`'o/%`ems >0/4z� /-4—
Remodel/TF _
Building owner address: Vet-✓?,9rt-1
Building owner phone #:
Name of Business: eotl71'rn"/ /oZ.-9
Proposed Use: (i.e. medical, office, bank, retail, etc) Q�7rwf'c e--
Project square footage: /U 0y
For commercial remodels £t tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an (please circle answer)
existing tenant or ew tenant?
➢ If for a new tenant, is this the first tenant to occupy this space? Yes or
➢ If not the initial tenant for this unit, what was the previous use of this tenant
Space? 1�))CAY e-
➢ Are there any exterior building changes associated with the work?
If yes, please describe:
Signature 6f applicant
Date
- �7
Yes or No
P%t_S -6/'7D— Z-,U-3--L,20
Name (please print) Local daytime phone #