HomeMy WebLinkAbout110 E Oak St - Applications/Tenant Finish - 07/07/2016List appropriate option
Metered: Yes or No Temp. Pedestal Yes or No
Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
material & profit) $ UP _ 1O'no
f° `, > COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 9160380 Z APPLICATION DATE
Job Site Address j) Oak 4 -ee- - Unit�
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PROPERTY OWNER INFO: (All owner information is required- it is not optional) Phone #/n,,�q "li/y- kW (o
Last name
First Name
Middle
Street Address 1)(9 /�_ 6a:X Ste•_ City-J-04 C6 State(: zip ?05��
CONTRACTOR INFO: Company Name rly��-��� �P(� �o�-J-1�j�Y11A-5 Contractor Phone # 7� �-6
Lic Holder Name 1k,'4 mow( I City of Fort Collins License # Supervisor Cert #
Mailing Address ��c �• ca��M?=e if-�Oco City G�t''��! � State l zip 'PO5-2-6-
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft # of Stories
15' Floor Sq Ft
2nd Floor Sq Ft
3rd Floor Sq Ft
Bldg Height # Dwelling Units
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/ Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ;I 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
Type of Heat: ❑ Gas ❑ Electric
Value of Construction
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR: C,�-OSk I -
Subcontractor Info:
Electrical Lmal cyo.,,A— 61a
I
Mechanical �1 �
u,r'10�ti• Llc -
Plumbing
_
Framer
Roofing
Concrete
Fireplace
Solar Other Other Other
Applicant: I hereby acknowtaffl
thigia
and state that the above information is correct and agree to comply with all requirements
contained herein and City oes s regulating building construction.
Applicant Signature Print Name_
ev1"r�25 Phone q 7 V
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City of Planning, Development and Transportation
F®rt Collins PO Box 580
281 N Cotlege. Ave
Ft Collins, CO 8052.4
970-221-6760 phone 970-224-6134fax
Commercial Construction Application Information
Revised 03/30/2009
Application Numb
Job Site Address:
New Building
Building owner:
Addition Remodel
Building owner address: lly baL 4. S4-!L ZZc—)
Building owner phone #: A"" -- Kf)cb qua -FLOG
Name of Business:
Proposed Use: (i.e. medical, office, bank, retail, etc) o r��� Ce--
Project square footage: 2 S(Dq
For commercial remodels Et tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an (pleasele answer)
existing tenant or ew to PPF
➢ If for a new tenant, is this the first tenant to occupy this space? Yes or
➢ If not the initial tenant for this unit, what was the previous use of this tenant
Space?
➢ Are there any exterior building changes associated with the work?
If yes, please describe:
Signature of applicant Date
Yes or Eo )
Name (please print) Local daytime phone #