HomeMy WebLinkAbout3665 John F Kennedy Pkwy - Applications/Tenant Finish - 12/21/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 8 I I 1 1(j;) 3 APPLICATION
Job Site Address 366 �- Gil' iA &,k l Unit # 1,90 q/- 12)1
PROPERTY LAGER INFO: (All owner Information Is required- it is not optional) Phone # < !D - a(?— ffza
Last name_ l/�)AI15l°✓1 7 First Name c� )� Middle
Street Address 40 lT/%7tiL` D l( �yr�P 6 �� City D /� U f'f /x__1 State�Zip qll'9J�v15
CONTRACTOR INFO: Company Name // %��� �/�C ?9/t r7 Contractor Phone # 9 `� ' �'/37
Lic Holder Name 'Ta Me's 9/ w/ % City of Fort Collins LiceLnse # ,F6� Supervisor Cert# q z"9
Mailing Address L2 /q� X / / � City 71 �Xke // State r� Zip
LEGAL INFO: /% %
Subdivision/PUD �YI^o d n Ceu �1'" e [ h ling # Lot.#_a Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) ?, 94 35<6 e Ii Total Garage Sq Ft
v /
Residential Sq Ft ) Comm9 Sq Ft # of Stories Bldg Height .76 # Dwelling Units
V4 Floor Sq Ft G 3P 2^° Floor Sq Ft 3- Floor Sq Ft T1Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/ Baths 1�_ # of Fireplaces
Air Conditioning: Ye, 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 #
List appropriate option #s
UTILITIES INFO: a
Water Tap Size Sewer Tap Size Metered: Yes 11NoF1 Temp. Pedestal Yes❑ No
Type of Heat: ErGas ❑Electric Electric Main Breaker Size (Residential only) F-1150 Amp or Less ❑ 200 Amp DOther
Value of Construction (including labor, material & profit) $<7
Subcontracttorr Info:
Electrical
�(/I / `/�Gti V tr l� �j� Mechanical /i G�� Plumbing
FramerU _ Roofing A hI'l,/'— Concrete A 2917 e Fireplace jjzP Je
Solar 11,PAe'_ Other
Other Other
Applicant: I hereby acknowtodge that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and Ci Fort Collins ordinan s and state laws regulating building construction.
Applicant Signature Print Name2 9 Phone
Distribution: White - Office Yellow - Applicant Pink - VWVW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City of Planning, Development and Transportation
F®rt 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 Numb
Job Site Address:
New Building
Building owner:
Addition Remodel/TF —7�F
Building owner address: #U/`Se-iLP4 �aa' 4e 14U
Building owner phone #:
Name of Business: /ZD/—O tIye4/VW ��d � r' te&1Q4,7�-
Proposed Use: (i.e. medical, office, bank, retail, etc) eP
Project square footage: J�U�
For commercial remodels Ft tenant finishes, please answer the following questions:
➢ Is the remodel/tenant—finishes for an (please circle 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 i
Space? _
for this unit, what was the previous use of this tenant
➢ Are there any exterior building changes associated with the work? Yes or No
If yes, please describe:
ignature of applicant
Name (please print)
l2-
Date
q1D -16q lAO-
Local daytime phone #
M
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