HomeMy WebLinkAbout1103 W Prospect Rd - Applications/Tenant Finish - 01/10/2014City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER LI Ob I Z D APPLICATION DATE
Job Site Address 1103 W. Prospect Rd. (Existing Rite Aid) Unit #
PROPERTY OWNER INFO: (All owner information is required - It is not optional) Phone # 970-221-3073
Last name Figueroc First Name Derel Middle
Street Address 1103 W. Prospect Rd. City Fort Collins State CO Zip 8M26
CONTRACTOR INFO: Company Name T.B.D.
Lic Holder Name
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD APN #97221-61-003 Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 17,184 Total Garage Sq Ft
Residential �Sq Ft Comm9 Sq Ft 17,184 # of Stories 1 Bldg Height +-20' # Dwelling Units
Ist Floor Sq Ft
2nd Floor Sq Ft
3' Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/4 Baths /z Baths # of Fireplaces
Air Conditioning: Ye✓ No0 Energy info:( Circle appropriate choice) 1. ComCheck Z 2. ResCheck w/Air Sealing11
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative El 5. Prescriptive w/Air Sealing11 6. Prescriptive w/ Blower Doom
City of Fort Collins Stock Plan #
List appropriate option #s
UTILITIES INFO:
Water Tap Size Existing Sewer Tap Size Existing Metered: Yes FV]NoF—1 Temp. Pedestal Yes❑ No W]
Type of Heat: R1 Gas Electric Electric Main Breaker Size (Residential only) 0150 Amp or Less 11 200 Amp Other
Value of Construction (including labor, material & profit) $ 40,000
Description of Work:
The scope of work includes changing the existing waiting area into a consultation room and relocating the waiting room
into the sales floor. Remove and replace the existing photo area with new. Remove and replace the soffit on the existing
walk-in ennlar/frPP7Pr Aria i ipgrnriac to the eyictin_q parking and restronmS
Contact Name & Phone # of JOBSITE SUPERVISOR: T.B.D.
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
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 ordinances and state laws regulating building construction.
Applicant Signatur Print Name Greg Borchardt Phone 916-226-5495
Distribution: White -Office Yellow -Applicant Pink -WWW(Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City of Planning, Development and Transportation
_F®r# 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: 110 3 v,' • P T,'o S P�� 2�•
New Building
Addition
Building owner: D F::,mlyL Fl &U 6rzc;t'--
Remodel/TF I) 3 F9
Building owner address: \kD3 \✓• '9rLtsP5�c--T RD.
Building owner phone #:
Name of Business: R��TE ��•
Proposed Use: (i.e. medical, office, bank, retail, etc)�-
Project square footage: 1-21 lS- %-t
For commercial remodels & tenant finishes, please answer the following questions:
➢ Is the remode tt shes for an (please circle answer)
fisting 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? A/./4
➢ Are there any exterior building changes associated with the work? Yes or(:v
- If yes, please describe:
Signature of applicant
Date
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G`CZ�� TSoRcH�►2� oil6,22(�.S
Name (please print) Local daytime phone #