HomeMy WebLinkAbout4856 Innovation Dr - Applications/Tenant Finish - 01/08/2014City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FOI t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ wvvw.fcgov.com/building Z
BUILDING PERMIT APPLICATION
APPLICATION NUMBER Z-i 60OLO 9 APPLICATION DATE
Job Site Address Dr. Unit #.
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #
Last name A re7d- - First Name �l� Middle
Street Address 46564e �br. City
CONTRACTOR INFO: Company Name Contractor Phone #_
Lic Holder Name
Mailing Address_
LEGALINFO:
Subdivision/PUD
City of Fort Collins License # Supervisor Cert #_
City State Zip
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft AQZ # of Stories Bldg Height # Dwelling Units
1 s' Floor Sq FL223gjr7 " 2nd Floor Sq Ft 31d Floor Sq Ft Unfiished Bsmt Sq Ft _
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths /2 Baths # of Fireplaces
Air Conditionin : 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 2rElectric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
v0
Value of Construction (including labor, material & profit) $ 743.57 S
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
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 Co ' s ordinanc nd state laws regulating building construction.
Applicant Signature Print Name k�—VrN L K.c%cy Phone305 - 94Yo"7?7Z
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
Ci of L-1 �y
Fort Collins PO BoxPlanniDevelopment and Transportation
281.N College Ave
lFt Colins IC0180524
f '1970=Z21 6760 phohe 970-224 6134 fax
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Commercial Construction Application Information
Revised 03/30/2009
Application Number: 0i f qC r!?C & S -
Job Site Address: g 0.,
New Building
Building owner:
Addition
Remod /TF ✓
Building owner address: 9'5z� d` �f ���y uh ��^•
Building owner phone #:
Name of Business:
Proposed Use: (i.e. medical, office, bank, retail, etc) Oje CtO I .
Project square footage: is 04 9/ LZ _ / R�
For commercial remodels h tenant finishes, please answer the following questions:
➢ Is the remo nanthes for an (please circle answer)
existing tenantP 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?
➢ Are there any exterior building changes associated with the work? Ye or No
If yes, please describe:
S' ature a i nt
Name (ptease print)
Date
-%5C717z
Local daytime phone #