HomeMy WebLinkAbout3665 John F Kennedy Pkwy - Applications/Tenant Finish - 02/19/2014City of I I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rt Collins 281 N. College Ave. - Fort Collins, CO 80524 - Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER N 1 tLJ L/" t lJ APPLICATION
Job Site Address J6,i�,r t( CP_ ���� .l,c.c gZ Z - Unit # 3 3a
PROPERTY OWNER INFO: (All owner Information is required - it is not optional) Phone # 65 2,- -3 3 -0
Last name L/y` i`I7�eft5lo�n First Name_ _ � �(S Middle e^
Street Address �0 3� �P�/!l Drt� //i. fCity �O j� State_Z�Zip 5 d,.!
CONTRACTOR INFO: Company Name 8�`_)W>q 8 U / /Q' 6/L-� Contractor/Phone #
Lic Holder Name 11 A jn 10 j r� / 7� l ki {l City of Fort
CollinslieLicense # i - 6 Supervisor Cart # !J —d Y
Mailing Address lPb /� �' t' �� City /�) //! ilci7i�% State_ Zip
LEGAL INFO:
Subdivision/PUD �Tf?v1 r�Arf ` `� �T�;,?A� Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft
1" Floor Sq Ft
Finished Bsmt Sq Ft
Comm'I Sq Ft' t_ # of Stories Bldg Height # Dwelling Units
_ 2nd Floor Sq Ft 3 d Floor Sq Ft � Unfiished Bsmt Sq Ft _
# of Bedrooms # of Full Baths % Baths /2 Baths # of Fireplaces
0
Air Conditioning: YeeNon Energy info:( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door ❑4. Simulated Performance Alternative❑ S. Prescriptive w/Air Sealing a 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
Water Tap Size It ewer Tap Si I� etered: Yes [EINo❑ Temp. Pedestal Yes❑ No 12
Type of Heat�as Electric Electric Main Breaker
Size (Residential only) �150 Amp or Less ❑ 200 Amp Other
Value of Construction (including labor, material & profit) $ /s J-dfJ, /wi'--top
- . r, Il:MR'15 11MrMEiRrC
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical (jkG l tI :, 6 !/ le-14%I�L Mechanical Ld ije ! 1�//I/Il�s�i//%Gd/ Plumbing 1�/7( G i
Frame C'i /T / oofing �Y 14 Concrete I I[ fY Fireplace /y ,4
Solar Other Other Other
Applicant: I hereby ac ledge that 1 have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and ity f Fort Collins ordinances and state laws regulating building construction.
O /2
Applicant Signatur� / Print Names-4 &_-n r l'n Phone
Distrbution: White -Office Yellow -Applicant Pink -WWW/Storrnwater
City of Planning, Development and Transportation
Fort Collins Po Box 580
281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134 fax
Commercial Construction Application Information
Revised 03/30/2009
Application Number:
Job Site Address:
New Building
Addition
Remodel/TF 4____
Building owner: _4:22tZi
Building owner address: VaaupAt� P1 a"le 5 w& �/O l
Building owner phone #:
Name of Business: ,� /iy
Proposed Use: (i.e. medical, office, bank, retail, etc) ocGl46,
Project square footage: GM -
For commercial remodels Et tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an (pleas c e answer)
existing tenant or new tenant
➢ If for a new tenant, is this the first tenant to occupy this space? Yes or
➢ If not the ini la Aenant for this unit, what was the previous use of this tenant
Space? t9T FLL
➢ Are there any exterior building changes associated with the work? Yes or No
If yes, please describe:
Name (please
2,-14-1
bate
Local daytime phone #
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