HomeMy WebLinkAbout2808 Ringneck Dr - Applications/Addition or Alteration - 08/30/2019City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
t Collins
281 N. College Ave. •Fort Collins, CO 80524 • Phone: 970.416.2740 • www.fczov.com/building
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BUILDING PERMIT APPLICATION
(� FOR OFFICE USE /�,
APPLICATION NUMBER: �' cj � v -1 01 2— APPLICATION DATE: "b 1 `Z� 19
Job Site Address P S0 2 ec k V,
Unit#
PROPERTY OWNER INFO: (All owner information is required — NOT optional)
Last Name 4j 1 uN First Name 10 r. Middle S,
Street Address 1%33 W )h4,.'.S 54-, ppl-I City ev, U e r State Cc Zip 90.2i$ - 129,?
Phone # q % —9 g r 3 S_3 0 Email Pc. /4 ; CD
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name /ties-tre f u dePS
License Holder Name Do -IL S C'� Lt LIC # 09 —60 CERT #?,O(& & — D -
LEGAL INFO:
Subdivision/PUD Filing # Lot #
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement)
Residential Sq Ft Commercial Sq Ft # of Stories_
1st Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft
Finished Basement Sq Ft
Baths Y2 Baths _
ENERGY INFORMATION: (CHECK ONE)
# of Bedrooms
# Fireplaces
Block # Lot Sq Ft
Total Garage Sq. Ft.
Bldg Ht # of Dwelling Units
Unfinished Basement Sq Ft
# of Full Baths
ComCheck ❑ UA (ResCheck) ❑ SPA (Simulated Performance ❑ prescriptive❑
Alternative)
Air Conditioning? YES ❑ NO ❑
City of Fort Collins Approved Stock Plan # SPO List Option #s
UTILITIES INFO: Gas ❑ Electric ❑ Electric Temp. Pedestal
Electric Main Breaker Size (Residential Only): 150 amp or less ❑
ZONING INFO: (COMMERCIAL USE ONLY)
ERI(Energy Rating Index) ❑
Yes ❑ No ❑
200 Amp ❑ Other ❑
Proposed Use: (i.e. medical, office, bank, retail, etc.)
For Commercial remodels and tenant finishes, please answer the following questions:
Is the remodel/tenant finishes for an existing or new tenant? (Please check one)
Existing Tenant❑ New Tenant❑
If for a new tenant, is this the first tenant to occupy this space?
Yes ❑ No ❑ If not for the initial tenant for this unit, what was the previous use of this tenant space?
Are there any exterior building changes (including mechanical) associated with the work? Yes ❑ No 01
If yes, please describe:
Value of Construction (materials and labor):
Description of Work: foll,,nor bA-ff-,l*uo+r q Iterc-L, ov , r aa
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JOBSITE SUPERVISOR CONTACT INFO: Name a^ lyca It Phone 970 - IT/ - Q It
SUBCONTRACTOR INFO: Electrical
Plumbing
Fireplace
Framing
Solar
Mechanical
Roofing
Other
ASBESTOS STATEMENT DISCLOSURE: in accordance with the State of Colorado Senate Bill 13-152, property owners, applying for a
remodel permit shall indicate their awareness about their property having been inspected for Asbestos Containing Materials (ACM's).
Ck I do not know if an asbestos inspection has been conducted on this property.
❑ An asbestos inspection has been conducted on this property on or about (enter date)
❑ An asbestos inspection has not been conducted on this property.
Applicant: I hereby acknowledge that I have read this application and state that the above information is correct and agree to
comply with all requireme contained herein and City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature Type or Print Name L,b (o IL
Phone# 97o-?2y--go 9.7 Email kesLrc-1 LL"/tiers �0AT-took.e-op^
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE