HomeMy WebLinkAbout110 N College Ave - Applications/Addition or Alteration - 05/25/2011COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
City of
F6rt Collins
APPLICATION NUMB
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov.com/building ff��
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BUILDING PERMIT APPLICATION
APPLICATION DATE _ : zg_l— ) /
Job Site Address 11ID. iA • .1k12Ge (4\). %0571- Unit #
PROPERTY OWNER INFO: AAII owner information is required - it is not optional) Phone #
Last name AVm w LL First Name Middle
Street Address City�_h4-k- 0Wl1� State �� Zipr� 5Z
CONTRACTOR INFO: Company Name Ujj C((J In Cor(lS�dt�j-)yj Contractor Phone # q�� ' ZZ ' "1 ���
Lic Holder Name Skte. i--� City of Fort Collins
^ License # Supervisor Cert #
Mailing Address 'so I S. ba (_0 • City nif CAI State C O Zip
LEGAL INFO:
Subdivision/PUD /� 111D (� Filing # Lot # Block # D Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft
151 Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/z Baths # of Fireplaces
Air Conditioning: 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 ❑ Electric Electric Main Breaker Size (Residential only) 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (inclupding labor, material & profit) $ ✓ d Z A4
Description of Work: A( (can 6�- jnPAA3 AaiMtYID/ INIYELOlIt 40 :QtC� P a �t1i��(1�i
Ia1ot.1� W.
Contact Name & Phone # of JOBSITE SUPERVISOR: `�-1'P��12 b �m (A 91 bq p ' Sb4-7
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 Signature � Print Name-h24-r/1/e Uj pmo Za) Phone (,(.J
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City of Planning, Development and Transportation
®rt Collins PO Box 580
281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134fax
Commercial Construction Application Information
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Application Number:
Job Site Address:
New Building
Building owner:
Building owner address:
Building owner phone #:
Name of Business:
Addition
Remodel/TF X
Proposed Use: (i.e. medical, office, bank, retail, etc) ZP-k-Ai
Project square footage: � d 5?E
For commercial remodels & tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an (please circle answer)
existing tenant Dor 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? es or No
If yes, please describe: 1 vl5+� 11(L+t on hL c V1 t� wr cA c anJ
Signature of applica
Name (pl'ease print)
51Z�1 I
bate
Local daytime phone #
S1uate