HomeMy WebLinkAbout706 Mcgraw Cir - Applications/Basement Finish - 12/19/20184-
City COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FortCollins
281 N. College Ave. •Fort Collins, CO 80524 •Phone: 970.416.2740 • www.fceov.com/building
BUILDING PERMIT APPLICATION
FOR OFFICE USE
4PPLICATION NUMBER:APPLICATION DATE:
Job Site Address 0� NLGG (�,v , l (� S (� gOt2-� Unit#
PROPERTY OWNER INFO: (All owner information is required — NOT optional)
Last Name W P l First Namey Middle
Street Address3o6 N�66zc"w Gfy City GPLL�-WS State C-6 Zip
Phone # 94_ p GqO &31 Z Email �W Ci Yvc�iRbox (l3 nGl �P. Go m
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name
License Holder Name LIC # CERT #
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) Total Garage Sq. Ft.
Residential Sq Ft Commercial Sq Ft # of Stories Bldg Ht # of Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft Unfinished Basement Sq Ft_
Finished Basement Sq Ft 97-) # of Bedrooms (` # of Full Baths
Baths % Baths ( # Fireplaces
ENERGY INFORMATION: (CHECK ONE)
ComCheck ❑ UA (ResCheck) ❑ SPA(Simulated Performance ❑ prescriptive❑
Alternative)
Air Conditioning? YES ❑ NO ❑
City of Fort Collins Approved Stock Plan # SPO List Option #s
ERI(Energy Rating Index) ❑
UTILITIES INFO: Gas ❑ Electric ❑ Electric Temp. Pedestal Yes ❑ No ❑
Electric Main Breaker Size (Residential Only): 150 amp or less ❑ 200 Amp ❑ Other ❑
ZONING INFO: (COMMERCIAL USE ONLY)
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 ❑
If yes, please describe:
Value of Construction (materials and labor], $ /Ap�
Description of Work: k a hc�vVVL -P_ 'r U,; o— hct�I, Ira h2La�ivv,
JOBSITE SUPERVISOR CONTACT INFO: Name
SUBCONTRACTOR INFO: Electrical
Plumbing
Fireplace
Framing
Solar
W e- ,
Phone TW 6Q0&b1L
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 forAsbestos Containing Materials (ACM's).
Im
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 requirements contained herein and City of Fort Collins ordinances and state laws regulating building construction.
\
Applicant Signature �/ ��' Type or Print Name I U W e, 1
Phone # °(_bti o v Email YW P- wla,� k box C4), % u ZA. to v� ,
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE