HomeMy WebLinkAbout3007 Dunbar Ave - Applications/Addition or Alteration - 08/06/2019City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fit Cottins
281 N. College Ave. •Fort Collins, CO 80524 •Phone: 970.416.2740 o evww.fcgov.com/building
BUILDING PERMIT APPLICATION
FOR OFFICE USE O I
APPLICATION NUMBER: I CI �APPLICATION DATE: I
Job Site Address 3009 ZXVAk JUnit#'
PROPERTY OWNER INFO: (All owner information is required — NOT optional)
Last Name (, cLere� First Name �(,ty�e�/ems �--a Middle
Street Address 3(j��i t,y��City ,^- f!! (fo `�i t s State Co Zip
Phone #�3_��Si0 Email i_i_vd. L'PiU C_ 2100_ O_rrr
o fflrG I
Ik
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name I-}owle cw&er
License Holder Name LIC # CERT #
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) _l "60 r Total Garage Sq. Ft. _ %�SF
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
Finished Basement Sq Ft j # of Bedrooms
Baths % Baths # Fireplaces
ENERGY INFORMATION: (CHECK ONE)
ComCheck ElUA (ResCheck) ElSPA(SimulatPerformance ❑
Alternative)
Air Conditioning? YES 2-' NO ❑
Unfinished Basement Sq Ft
# of Full Baths
Prescriptive❑ ERI(Energy Rating Index) ❑
City of Fort Collins Approved Stock Plan # SPO List Option #s
UTILITIES INFO: Gas Electric L" Electric Temp. Pedestal
Electric Main Breaker Size (Residential Only): 150 amp or less 2-0�-
ZONING INFO: (COMMERCIAL USE ONLY)
Proposed Use: (i.e. medical, office, bank, retail, etc.)
Yes ❑ No ❑
200 Amp ❑ Other ❑
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):
S,',
Name
$M60k&1 QS )ooYb�
SUBCONTRACTOR INFO: Electrical e owo &a Mechanical
Plumbing P(* Framing
Fireplace
Solar
Sr
Phone
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).
❑ 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)
L� An asbestos inspection has not been conducted on this property.
Applicant: I hereby ack ge that I hav ead this application and state that the above information is correct and agree to
comply with all req ' aments ontained ein and City of Fort Collins ordinances and state laws regulating building construction.
Applicant Sig ture Type or Print Name �—� U Iwj /�—
Phone# p�3�—�j�j�(� Email � �LC% o� �Yq 1160_��
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE