HomeMy WebLinkAbout2155 Romney Ave - Applications/Addition or Alteration - 03/05/2020City of
Flirt Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, Co 80524 • Phone: 970.416.2740 • www.fcgov.com/building
BUILDING PERMIT APPLICATION
C1U,31-p
FOR OFFICE USE
IkPPLICATION NUMBER: �0I APPLICATION DATE: 3 S �.17
Job Site Address Q 15 5 Qr,t� Nc-4 J� VF Unit#
PROPERTY OWNER INFO: (All owner information is required — NOT optional)
Last Name First Name MGCr Middle
Street Address 21 S5yomaj2y �— City t'ro iz c rr) u-1�j State CV Zip 005a4o
Phone # 505 220 `357 j Email M11A15O.K j2, 00i` 41L-, %oM
Name of Business (COMMERCIAL USE ONLY)
CONTRACTORINFO: Company Name N1kGHT`J µkiAD NAS- emc— '0
1k
License Holder Name �H '` � C IK C'VotJ Ly LIC # 9 $q$ CERT # H51 `i —D k
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) Total Garage Sq. Ft.
Residential Sq Ft 92a,0 Commercial Sq Ft # of Stories Bldg Ht # of Dwelling Units
1st Floor Sq Ft 1110 2nd Floor Sq Ft 3rd Floor Sq Ft Unfinished Basement Sq Ft
Finished Basement Sq Ft 4% # of Bedrooms # of Full Baths 3
Baths % Baths # Fireplaces
ENERGY INFORMATION: (CHECK ONE)
ComCheck ❑ UA (ResCheck) ❑ SPA(Simulated Performance ❑ Prescriptive[] ERI (Energy Rating Index) ❑
Alternative)
Air Conditioning? YES ❑ NO ❑
City of Fort Collins Approved Stock Plan # SPO List Option #s
UTILITIES INFO: Gas ❑ Electric.21' 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.)
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 lab r : $ (b/ Dion
Description of Work: K-rTCHE INSCLU17)W& N9W GRpiNelr
(A %-i N T&i?5 t A ,� r? 2j�.--M ar pr L� of A PA ?-Ti a 11/b' Lon-v
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JOBSITE SUPERVISOR CONTACT INFO: Name jlpo(w
Phone q_)O
t3J A
g0oj-�
SUBCONTRACTOR INFO: Electrical "%CC- LV.
Mechanical 12+ P Lti9AMr4b
J4:
MZ
Plumbing pt,Vmgulfo f H&rcf,46
Fireplace , 'MAUs`s
Framing IAWyrk-y K";? Roofing
Solar
Other F k(, Crrd WI%
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)
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 CULcd;Eort Collins ordinances and state laws regulating building construction.
Applicant Signature Type or Print Name
Phone# ' `1 Email 510PI "(2, M16Hry L'
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE