HomeMy WebLinkAbout712 Columbia Rd - Applications/Other - 09/16/2019City of � ,
�QtW 9 ��� I� COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
291 N. College Ave. • Fort Collins, CO 90524 • Phone: 970.416.2740 •
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BUILDING PERMIT APPLICATION
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APPLICATION NUMBER: . P L D b�y j APPLICATION DATE.- - q I ly 1101
Job Site Address 712 Columbia Rd
PROPERTY OWNER INFO: (All owner information is required - NOT optional)
Unit#
Last Name Gates First Name Devon Middle I16{k ! -L
Street Address 712 Columbia Rd City Fort Collins State CO Zip 80525
Phone# 7c2UfoZ'/6513 Email J] Gj(QQL%�M'gT CCa`7.
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name NA
License Holder Name
LEGAL INFO:
Subdivision/PUD Filing # Lot #
CONSTRUCTION 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 # of Bedrooms
Y4 Baths % Baths # Fireplaces
LIC # CERT #
Block # Lot Sq Ft
Total Garage Sq. Ft.
Bldg Ht # of Dwelling Units
Unfinished Basement Sq Ft
—
# of Full Baths
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.) hiedfcot l - Pkas6/1 aC(.(lii' 0alIq�ip�
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 Tenanti New Tenant❑
If for a new tenant, is this the first tenant to occupy this space?
Yes ❑ No ❑ If not for the initial tenant forthis 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): $ 8600
Description of Work: Construction of an 8 foot fence around existing property. Fence height approved per Tom Leeson
based on resonable accommodation request 8/14/2019.
Engineers letter approved by Russ Hovland
LRL Construction to installed fence based on approved engineers letter.
JOBSITE SUPERVISOR CONTACT INFO: Name
SUBCONTRACTOR INFO: Electrical /VIA
Liestman Phone 970-308-9428
Mechanical /V�I
Plumbing I ZA Framing •Aj1A Roofing N44
Fireplace N1/4 Solar Al ZA 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).
An 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: 1 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 lk� Type or Print Name pey,,, �� S
Phone # 720 Email DQ 031 qq i C?rylQI V - GOB
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