HomeMy WebLinkAbout3313 Green Lake Dr - Applications/Single Family New - 08/29/2019 (3),�7
City of
fort Collins COMMUNITY DEVELOPMENT'& NEMHBORHOOD SERVICES
291 N. College Ave. • Fort Collins, CO so524 • Phone: 970.416.2740 s www.fcaov:com/building
BUILDING PERMIT APPurnTlnlnl
APPLICATION.NUMBER: 06, 05 FOROFFKE USEAPPLICATION DATE pZ� /
+ou Size Address
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PROPERTY OWNER INFO: (All owner information is
Unit#
— NOT optional)
Last Name ��1qe15 First Name UZI Middle
u�4 s
Street Address 31011 K4fif crcity (4jlAJ OWIC State C i zip
Phone # 910 Email T&A
Name of Business (coMMERCIAL use ONLY)
CONTRACTOR INFO: Company Name r(�y-gyp
License Holder Name C9-A 3"p LIC # ^ 13 �-CERT It 30-A GZ,
LEGAL INFO:
Subdivision/PUD . jW Filing # Lot # 3Block # Z Lot Sq Ft ;453if
CONSTRUCiON INFO: Total Building
Sq Ft (NOT including basement) 11 y3 Total Garage Sq. Ft.
Residential Sq Ft - commercial Sq Ft # of Stories y Bldg Ht .:34 # of Dwelling Units
1st. Floor Sq Ft 2nd Floor Sq Ft -ry'�� 3rd Floor Sq Ft / Unfinished Basement Sq Ft
Finished Baserlten Sq Ft / # o edrooms# of Full Baths Z
3/ Baths / Y. Baths T� # Fireplaces r'
ENERGY INFORMATION: (CHECK ONE)
ComCheek ❑ UA (ResCheck) ❑ SPA( emulated Performance
Iternative) Prescriptive[] ERI(Energy Rating Index) ❑
Air Conditioning? YES NO ❑
City of Fort Collins Approved Stock Plan # SPO List Option #s
UTILITIES INFO: Gas Electric 19 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: ft e. medical, office, bank, retail, etc.)
For Commercial remodels and tenant finishes lease answer the followinquestions:
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:
\.Q
Value of Construction ( naterlals and labor.): $
Descri tion of Work: .— 3 e �
106517E SUPERVISOR CONTACT INFO: Name \
SUBCONTRACTOR INFO: Electrical �l ►(,p� Mechanical
Plumbing • P , S Framing Ro
Fire In
Phone
rGt-IH-
ofing (I(1
P Solar
Other
ASBESTOS STATEMENT DISCLOSURE: In accordance with the State of Colorado Senate Bill 13-152, property owners applying
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remodel permit, shall Indicate their awareness about their property having been inspected forAebestos Containing Materials (Afor o
❑ 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 c ducted on this property.
Applicant: 1 hereby acknowledge �11a'� have d this application and state that the above Information Is correct and agree to
comply with all requirement�c I lr�d her nd City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature / Type or Pri t Nam _ cuiI 3� ,
Phone # �/' tp{7 Email
THIS APPLICATION EXPIRES 38®.DAYS FROM APPLICATION DATE