HomeMy WebLinkAbout619 S College Ave - Applications/Addition or Alteration - 03/09/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
wwwAcgov corn/building
BUILDING PERMIT APPLICATION /
APPLICATION NUMBER II C� V �� APPLICATION DATE��
Job Site Address Gl Unit #Le
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # / �— 4� �" 303
Last name (�0.g��`G°+ !`-/�r�6�� First Name Middle
Street Address �, h t�'� -S City i l-'>J State Zip&-os- -
CONTRACTOR INFO: Company Name V>Aa' Gj \ L Contractor Phone # y :;t
I is Hnlder Name )Qi> ,,J, Citv of Fort Collins License # Supervisor Cert #
Mailing Address 0 ""'D4- City �.% ����"1 StateCJ Zip
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 5 6U Sr, f` Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft
15t Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
3m Floor Sq Ft
# of Bedrooms # of Full Baths 1/4 Baths
Unfiished Bsmt Sq Ft _
'/2 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 (including labor, material & profit) $ 6 edo' 00
Description of Work: 9" L L N% U'10-41
1^
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
ElectricalFoil&°N,-" k � L Mechanical
nn
Framer All- 4 Li Roofing
Solar
Other
ti
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge a h read this al2plication and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fo in ce n state laws regulating building const
ruction.
Applicant Signature Print Name /�- 9"C", �� Phone (T7,)
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City Of Planning, Development and Transportation
Fort Collins PO Box 580
281 N College Ave
Ft Cotlins, CO 80524
970-221-6760 phone 970-224-6134fax
Commercial Construction Application Information
Revised 03/30/2009
Application Number:
Job Site Address: �l�I• ���/��z ►� �� �(� 16
New Building
Building owner:
Addition
vz s
Remodel/TF i�
Building owner address: 3 L, ,�,e , S
Building owner phone #: 3037
Name of Business:
Proposed Use: (i.e. medical, office, bank, retail, etc)
Project square footage: L 6 LO
For commercial remodels £t tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an 4 answer)
existing tenant 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? O ` L� S � S
➢ Are there any exterior building changes associated with the work?
If yes, please describe:
Signature of applicant
Name (please print)
Date
Yes or 0
qW- 512- "') k
Local daytime phone #