HomeMy WebLinkAbout1255 Sherwood St - Applications/Garage - 08/07/2019City of
Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416.2740 • www fcgov.com/building
BUILDING PERMIT APPLICATION
FOR OFFICE USE
4PPLICATION NUMBER: �l (� O(ol o APPLICATION DATE:
Job Site Address jZ5 uniitr
PROPERTY OWNER INFO: (All owner information is required — NOT optional)
Last NameFirst Name Middle
Street Address 12S S Sf I ��D�itY ao�s State � Zip , �Zi
Phone # Email l,J(�_ I �U-iar+z c-gn c.-) , "-I 1 ic Q-en
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Name Of Business (COMMERCIAL USE ONLY) "—
CONTRACTOR INFO: Company Name - 1.1 C)-C> —FCA JLL '�+o-D1
License Holder Name 0J& 't6�-LIC #. � CERT # 2`!*[
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LEGALINFO:
Subdivision/PUD rTC Filing # Lot # L% Block # J� 1 Lot Sq Ft
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) Total Garage Sq. Ft. 216
Residential Sq Ft Commercial Sq Ft # of Stories Bldg Ht # of Dwelling Units 0
1st Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft Unfinished Basement Sq Ft
Finished Basement Sq Ft # of Bedrooms
3/ Baths �Y, Baths # Fireplaces _
ENERGY INFORMATION: (CHECK ONE)
ComCheck ❑ UA (ResCheck) ❑
Air Conditioning?
SPA Alternative)
Performance ❑
Alternative)
YES ❑ NO El
City of Fort Collins Approved Stock Plan # SPO
UTILITIES INFO: Gas ❑ Electric
Electric Main Breaker Size (Residential Only):
_# of Full Baths
Prescriptive❑
List Option #s
ERI(Energy Rating index) ❑
19 Electric Temp. Pedestal Yes
❑
No
�.
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): $ {J c.i kc-T- (✓1 i��, lal � R-�ry) i
Description of Work: ) c)QH 2 L0 a c.�x._ W�v rG�tcjt nc l L
cw t �5� L,
G.. O r -Z- rl 1 , t K) r .. rw 4 ►'c - L 7 (�ry� cr !�/� Ln✓t c I ✓ZGlni
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JOBSITE SUPERVISOR CONTACT INFO: NamePhone Z� can�J
SUBCONTRACTOR INFO: Electrical Z1l`weyifG (mil sllechanical
Plumbing
Fireplace r
Framing LeP>' DbUla Roofing,- �� Pzvry
Solar
Other
ASBESTOS STATEMENT DISCLOSURE: In accordance with the State of Colorado Senate Bill 13-152, property owners, applying for o
remodel permit, shall indicate their awareness about their property having been inspected for Asbestos Containing Materials (RCM's).
❑ I do not know if an asbestos inspection has been conducted on this property. 0OA-LL LLB
❑ 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 1 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 �"1�. F j (-� 0
Phone L6•d-7 - 903 Email —19-plZtbd rge;�S�-Cif �t"
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE