HomeMy WebLinkAbout2924 Council Tree Ave - Applications/Tenant Finish - 02/23/2010a
BUILDING PERMITS & INSPECTIONS DIVISION
EO Box 580 Fort CoWns CO 8052Z'0580 Phone 221-6760
www fcgov com/btuldutg
CrtyofFortColline BUILDING PERMIT APPLICATION
APPLICATION NUMBER l J 10 Q O 1 l0 Q APPLICATION DATE � 17,�V
Job Site Address 2924 COUNCIL TREE AVE Unit# 100
PROPERTY OWN ER- INFO (All owner information Is required -it is not optional) Phone # 205- 795-5525
Last Name GorbaCh First Name Rick Middle
Street Address 2222 Arlington Ave City Birmingham State AL Zip 35205 -
CONTRAS RQ INFO Company Name T B D Contractor Phone 0
Lie Holder Name_ - _-
City of Fort Collins License # Supervisor Cert #
Mailing Address City State
Subdivision/PUD NSA Filing # Lot # Block il Lot Sq Ft
gONSTRUCTION IN Total Building Sq Ft (not Including basement) 1 290 SQ FT Total Garage Sq Ft
Residential Sq Ft
Comm I Sq Ft
# of Stones Bldg Height
# Dwelling Units
1u Floor Sq Ft
2N Floor Sq Ft
Unflnlshed Bsmt Sq Ft
Finished Bsmt Sq Ft
# of Bedrooms
# of Full Baths
% Baths % Baths
# of Fireplaces _
Air Condldoning XYes
No Energy Info /Circle appropriate choke) t 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 # List appropriate option #s
UTILITIES INFO,
X X
Water Tap Size NSA__ Sewer Tap Size NSA Metered Yes or No Temp Pedestal Yes or No
Type of Heat 0 Gas O Electric Electric Main Breaker Size (RetggpypLoolill 50 Amp or Less 0 200 Amp O Other
Value of Construction (Including labor material 8 profit) i T V
DesmptionofWork INSTALLATION OF INTERIOR WALLS CREATING RESTR OM & HALL
MODIFICATION TO EXISTING STOREFRONT BY ADDING A STOREFRONT DOOR
NEW A C T CEILING WITH LIGHTING AND HVAC SYSTEM
Contact Name & Phone # of JOBSITE SUPERVISOR T B D
SubegnVActor Info, T B D
Electrical Mechanical
Plumbing
Framer Rooting Concrete 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 slate laws regulating budding construction
J -
Appllcant Signaturrq __ Print Nam'O� Phone
Distribution White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE
T/T d b£T9022 Ol ££8T£220L6 A3SSUW 3-IDNI-1 b3111:1 W021d LT 80 OT02-02-83d
Community Planning and Environmental Services
Fort Collins Neighborhood & Building Services
can of ror[touins 281 N College Ave P O Box 580 Fort Collins CO 80522 0580 Voice 970 2216760 FAX 970 224 6134
Commercial Construction Application Information
Revised March 6 2006
6100096E
Application Number
Job Site Address 212 A C.ovir cuL T"F- Xyr. Unit # I oo
New Budding Addition Remodel/TF ✓
Name of Business T:�R,)A r FkO trE REral L CO , ►--L
Proposed Use (i a medical, office, bank, retail, etc) RErhlt-.
Project square footage Ia.B 5 5 F
For commercial remodels and tenant finishes, please answer the following
❑ Is the remodel/tenant finish for an existing tenant or new
tenant? DIEM/
❑ If for a new tenant, is this the first tenant to occupy this
space? YES
❑ If not the initial tenant for this unit, what was the previous use of this
tenant space? (If known)
❑ Are there any exterior elevation changes associated with the
work? YES
Describe Ftvnlrtorl or- A SToREiwRctJT DooR
Sig ture
5�ro(L�Ac,�
Name Please print)
1.-3— c -0
Date
206 - Zg 5 - 55�k--5
Local daytime phone #