HomeMy WebLinkAbout120 W Olive St - Applications/Tenant Finish - 12/08/2009BUILDING PERMITS & INSPECTIONS DIVISION
EO. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
L� www.fcgov.com/building
Cityof®Fort BUILDING PERMIT APPLICATION
APPLICATION NUMBEz-
R APPLICATION DATE
Job Site Address Oleve-.54 Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last Name 7ZA AJ D First Name i'&0KC -T Middle u
Street Address )fib I/Li. 6LIVlE 5' • City FIT. LOLLIIJS State Cd zip g�Sz I
CONTRACTOR INFO: Company Name �J PrF LIAL BVl LDEQ- Contractor Phone
Lic. Holder Name rOIZE5 City of Fort Collins License # E' Supervisor Cert #
Mailing Address ;7 S• 5;W/ELP5 /Z7 City FOi-�:T COL.LIA%S State (� zip �0526
LEGALINFO:
Subdivision/PUD 9 %�� y �J�Q�() Filing # 176 Lot # 2 -1 Block # / I z Lot Sq Ft 3�C�
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) ZZ �iJ� Total Garage Sq Ft /� A
Residential Sq Ft l Comml Sq Ft # of Stories Bldg Height LO #Dwelling Units /��
1st Floor Sq Ft 2nd Floor Sq Ft —AA Unfinished Bsmt Sq Ft&%- Finished Bsmt Sq Ft I'JA �L
# of Bedrooms # of Full Baths % Baths Y2 Baths �_ # of Fireplaces l
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # 'y List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metere�r No Temp. Pedestal: Yes or
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) $�`� ' 00
Description of Work: ADDIAJL A T3OIL/My - LC--j7LE :/4001) Tff/S l cJ(LL 7GEQL7L
D(JG7-G c_} i4cTD fFDb/.uc' 4 F/_Q--�lL ]Xrz�IAJ TlfF- AZ-7- L- /�: ! Z 13o1LI-AQ
(U 4 ICiZ 6ti1L`/ ! EDOi) Ic ELM LEVAL A-r?A)CS ST�iA
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: n "'
Electrical sCAWCLk- 157ZE jC- Mechanical ZtA 80MA)6-� A/Z Plumbing
Framer /y�Q Roofing N�iE Concrete 1110 Other
2
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 ordi ances and state laws regulating building construction.
Applicant Signature Print Name F346-5�(r Phone A;7)
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE
4aCommunft Planning and Environmental Services
Building and Zoning Department
City of Fort Collins
Commercial Construction Application Information
Revised May 10, 2000
Application Number:
Job Site Address: / 2(n UJcsf (211'v2 52. Unit #
New Building Addition Remodel/TF
Name of Business: OL i VZ�- ST1 T 30qe-L--E:1
Proposed Use: (i.e. medical, office, bank, retail, etc) FA4LEY
Project square footage: Z 26S
For commercial remodels and tenant finishes, please answer the following:
❑ Is the remodel/tenant finish for an existing tenant or new
tenant? e/=( /A)Cs-
o If for a new tenant, is this the first tenant to occupy this
space? AAA
❑ If not the initial tenant for this unit, what was the previous use of this tenant space? (If
known) Nil
❑ Are there any exterior elevation changes associated with the
work? A30
Describe: /\J A
/ - �z7109
Signatur Date
Forl� TEE 470 2/7-69y6 o-r 2Zl-ISC7
Name (Please print) Local daytime phone #
281 North College Avenue • P.O. Box 580 • Fort Collins CO 80522-0580 • (970)221-6760 • FAX (970)224-6134