HomeMy WebLinkAbout430 N College Ave - Applications/Addition or Alteration - 12/14/2017COMMUNITY 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 EA W !!�'� APPLICATION DATE
Job Site Address 430 y�, (II�e�J�_ r_c�ll.�.5 Co c,3o5z4 Unit #
PROPERTY OWNER INFO. (All owner information is required - it is not optional) Phone #_
Last
First
Middle
Street Address City State Zip
i
CONTRACTOR INFO Company Name Ina 6�hi% Contractor Phone # !a7o �pa-ebo3
Lic Holder Name
City of Fort Collins License # Supervisor Cert #.
Mailing Address ZIS (1y,%r Ql City L)Jcr now State (D Zip E053(g
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'I Sq Ft i In D Sr- # of Stones
151 Floor Sq Ft
2ntl Floor Sq Ft
3" 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 ) 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:
List appropriate option
Water Tap Size Sewer Tap Size Metered Yes or No Temp Pedestal Yes or No
Type of Heat ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 'Doo . , 0
Description of Work
Contact Name & Phone # of JOBSITE SUPERVISOR. t Jr_. a jnrro..j giof q98-800S
Subcontractor Info:
Electrical
Framer Roofing
Solar Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant I hereby ac ovule a thjins
I have ead this pplication and state that the above information is correct and agree to comply with all requirements
contained herein and dy of Fo Cord ances d state laws regulating budding construction L(�
Applicant Signatur Print Name) lnv �, i raP/h� Phone 1lo'9erS -oo6-3
Distribution White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
F6City Of Planning, Development and Transportation
1 t C®Lli1 tiCalc PO Box 580
281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134fax
Commercial Construction Application Information
Revised 03/30/2009
Application Nurnber:`�'R 17 08 5 0.9
Job Site Address: 43L) A. 6 -,r-< e- ki
New Building Addition Remodel/TF
Building owner: __t JR
Building owner address:
Building owner phone #:
Name of Business:
Proposed Use: (i.e. medical, office, bank, retail, etc)
Project square footage:
For commercial remodels ft tenant finishes, please answer the following questions:
➢ Is the remodel/tenant_finishes for an (please circle answer)
e� �xisting t�NnO or new tenant?
➢ If for a new tenant, is this the first tenant to occupy this space? Yes or No
➢ 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? Yes or(N-Oill
If yes, please describe:
Name (please print) Local daytime phone #
M