HomeMy WebLinkAbout925 W Lake St - Applications/New Commercial - 12/23/2011COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
City of
Fort Collins
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER '✓ 1, I S% t4 APPLICATION DATE
Job Site Address 925 West Lake, Fort Collins, CO Unit # n/a
PROPERTY OWNER INFO: (All owner information is required- it Is not optional) Phone #
Last name Islamic Center of Fort Collins First Name Contact: Mumtaz Hussain
Middle n/a
Street Address 900 South Peterson City Fort Collins State CO zip 80524
CONTRACTOR INFO: Company Name Brinkman Construction Inc Contractor Phone # 970-267-0954
Lic Holder Name Paul Brinkman
City of Fort Collins License # B-361 Supervisor Cert #
Mailing Address 3003 East Harmony Rd, Ste 300 city Fort Collins
State CO Zip 80528
Subdivision/PUD Hidayah Village Subdivision Filing # Lot # Block # Lot Sq Ft 142,170
CONSTRUCTION INFO: Total Building Sq Ft (not Including basement) 11,600 Total Garage Sq Ft 0
Residential Sq Ft 0 Comm'I Sq Ft 11,600 # of Stories 2 Bldg Height 51'4" # Dwelling Units 0
tat Floor Sq Ft 6,900
F`-shed Bsmt Sq Ft 0
2"d Floor Sq Ft 4,700 31 Floor Sq Ft 0 Unfiished Bsmt Sq Ft 6,900
# of Bedrooms 0 # of Full Baths 2 % Baths 0 'Y2 Baths 0 # of Fireplaces 0
Zonditioning: Yer✓ No Energy info: ( Circle appropriate choice) 1. ComCheck ✓❑ 2. ResCheck w/Air Sealing11
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative El 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
of Fort Collins Stock Plan # n/a List appropriate option
Water Tap Size 3/4„ Sewer Tap Size 4" Metered: Yes ❑✓ No[] Temp. Pedestal Yesz No
Type of Heat: R] Gas ❑Electric Electric Main Breaker Size (Residential only) 1:1150 Amp or Less ❑ 200 Amp DOther
Value of Construction (including labor, material & profit) $ 1,965,337
Description of Work:
New construction, steel and concrete structure, stucco and GMU exterior. 11,600 gross square feet, two stories above
a full, unfinished basement.
Contact Name & Phone # of JOBSITE SUPERVISOR: Andy Looney, Brinkman Construction, 970-222-0310
Subcontractor Info:
Electrical Gregory Electric Mechanical Air Comfort
Framer n/a Roofing
Solar n/a Other
:ant: I hereby
cuntained herein an
Applicant
Roof Check
Plumbing Neuworks Mechanical
Concrete Pierson Concrete
Other
Fireplace n/a
Other
Wladg`e_tha ave read this applicntinn and state that the above information is correct and agree to comply with all requirements
of Fq0.eVIins ordinanc state laws_jRgulating building construction.
-Todd Parker, Brinkman Construciton Phone 970-267-0954
Distribution: White -Office Yellow -Applicant Pink -WWW/Stormwater
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Planning, Development & Transportation Services
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Community Development & Neighborhood Services
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281 North College Avenue
P.OBox 580
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Fort Collins, CO 80522.0580
970.416.2740
970.224.6134- fax
fcgov.com
Fee Verification Form
Address: qL-15 IAA %• S-r Application#: F� till
X1 New Building, ❑ Addition, ❑ Remodel, ❑ Other
Zone:
❑ New Use, ❑ Change of Use, ❑ Other
Use: ❑ Residential, ❑ Commercial, I] Industrial, ❑ Other
Number of Dwelling Units: SIC Code: Confirmed:
Occupancy #1: —3 ❑ New, ❑ Change, ❑ Existing, ❑ Other
Sq. Ft. Indicated: �� Square Footage Corrected:
Valuation Indicated: Valuation Corrected:
Occupancy #2: --'D' ' ❑ New, ❑ Change, ❑ Existing, ❑ Other
Sq. Ft. Indicated: CO oZj
Valuation Indicated:
Square Footage Corrected:
Valuation Corrected:
Occupancy 93: ❑ New, ❑ Change, ❑ Existing, ❑ Other
Sq. Ft. Indicated: _
Valuation Indicated:
Square Footage Corrected:
Valuation Corrected:
600)(13 1',,5 85) ��16/ /:�
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Zoning Staff: Date:
Plan Review Staff: Date: 2—
CSR Staff: Date:
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