HomeMy WebLinkAbout1611 S College Ave - Applications/Tenant Finish - 02/25/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rt Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE `
Job Site Address I (Q h S, (01 � I? , Unit # (� 3
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # —7 D 7A. b S 5
Last nameFirst Na
Middle
Street Address City QfACOLO. js State Zip f)bSzy
CONTRACTOR INFO: Company Name jh��cr QxP Cor,6t . 1 NL. Contractor Phone # a �o Z t R Z
Lic Holder Name S -ejc IrA!p City of Fort Collins License # $ Supervisor Cert #
Mailing Address S . LI NIL lL Yl-e. City FbC \- COI jjfT�:, State CCU Zip 805Z-1
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
1s' Floor Sq Ft
Finished Bsmt Sq Ft
2°d Floor Sq Ft
Filing #
ement)
# of Stories
Lot #
31d Floor Sq Ft
Bldg Height.
# of Bedrooms # of Full Baths % Baths
Block # Lot Sq Ft
Total Garage Sq Ft
# Dwelling Units
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:
Water Tap Size Sewer Tap Size
List appropriate option
vJ
Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other CV
Metered: Yes or No Temp. Pedestal Yes or No
Value of Construction (including labor, material & profit) $ (061 22 t
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: v
t (�
Electrical �� 5 Mechanical 4\i t!o& -�� CPlumbing
Framer Roofing Concrete Fireplace
Solar Other Other Other
Applicant: I hereby acknowledge that I have re d this a plica n and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort I' s ordina es an stat I ws regulating building construction.
Applicant Signature PaaLName (9� 1�t- Phone 2Z�( • �czCT�
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City/ Of Planning, Development and Transportation
Frt Collins PO Box 580
281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134 fax
Commercial Construction Application Information
Revised 03/30/2009
Application Number:
Job Site Address:
New Building Addition
Building owner:
Building owner address:
Building owner phone #:
Remodel/TF -Tl—
MMOM
Name of Business: k/
Proposed Use: (i.e. medical, office, bank, retail, etc) lCe l f
Project square footage:
For commercial remodels It tenant finishes, please answer the following questions:
➢ Is the re shes for EnVrja
e nswer)
or N eLt/') Te,Yv 4)--IN -'F
➢ If for a new tenant, is this the first tenant to occupy this space? Yes or
➢ If not the initial tenant for this unit wha was the previous use of this tenant
Space? UA,"- a 1 -- Za,&Y.4 � /L
➢ Are there any exterior building changes associated with the work?
If yes, please describe:
Signature of applicant
Date
Yes or oD
Name (please print) Local daytime phone #