HomeMy WebLinkAbout319 E Magnolia St - Applications/Addition or Alteration - 11/27/2018`1
City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416.2740 • www.fcQov.com/building
BUILDING PERMIT APPLICATION
FOR OFFICE USE
APPLICATION NUMBER: eol 62� 1 1 APPLICATION DATE:
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PROPERTY OWNER INFO: (All owner information is required - NOT optional)
Last Name Josephs First Name Kelly And Steve Middle
Street Address 319 E. Magnolia St. City Ft Collins Co. State Co Zip 80524
Phone # 970-217-0261 Email skjosephs@msn.Com
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name
License Holder Name
LIC # CERT #
LEGAL INFO:
Subdivision/PUD Filing# Lot# Block# Lot SgFt
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) Total Garage Sq. Ft.
Residential Sq Ft_[32,,o Commercial Sq Ft # of Stories Bldg Ht # of Dwelling Units
1st Floor Sq Ft �_2nd Floor Sq Ft (I n () 3rd Floor Sq Ft Unfinished Basement Sq Ft
Finished Basement Sq Ft # of Bedrooms # of Full Baths
Baths Y2 Baths # Fireplaces
ENGERGY INFORMATION: (CHECK ONE)
ComCheCk El UA (ResCheck) El SPA
Performance ❑ PrescriptiveERI(Energy Rating Index) ElAlternative)
Air Conditioning? YES a NO ❑
City of Fort Collins Approved Stock Plan # SPO
List Option #s
UTILITIES INFO: Gas S Electric ❑ Electric Temp. Pedestal Yes ❑ No ❑
Electric Main Breaker Size (Residential Only): 150 amp or less 8 200 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 El
If yes, please describe:
Value of Construction (materials and labor):
Description of work: remodel of existing
JOBSITE SUPERVISOR CONTACT INFO: Name
SUBCONTRACTOR INFO: Electrical
Plumbing
Fireplace
Framing
Solar
space
Phone
Mechanical
Roofing
Other
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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 (RCM's).
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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 Vet .i
Phone # of 7(D. 21 . U Email ST czv�n
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE