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HomeMy WebLinkAbout506 Larkbunting Dr - Applications/Addition or Alteration - 02/28/2019City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES tO« t1S 281 N. College Ave. •Fort Collins, CO 80524 •Phone: 970.416.2740 • www.fc¢ov.com/buildine BUILDING PERMIT APPLICATION �' 1(1 FOR OFFICE USE APPLICATION NUMBER: 1 Iq 1 AU APPLICATION DATE: Job Site Address So & LA" oiuriy, D& Unit# PROPERTY OWNER INFO: (All owner information is Last Name Q 0t4 ) f , Nj_'2 First Name Street Address 5 06 � ¢�11,�a� &Z City Phone #. 970 _ 1/3o -237a Email Name of Business (COMMERCIAL USE ONLY) — NOT optional) Middle �, WS State CO . Zip CONTRACTOR INFO: Company Name C4-`y/�j pvU �/ lac>ws License Holder Name LIC # CERT # LEGAL INFO: Subdivision/PUD 44emawyA# Filing # Lot # Block # _LL_Lot Sq Ft J_3�� CONSTRUCTION INFO: Total Building Sq Ft (NOT including basement) /,Z Total Garage Sq. Ft. L�a� 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 Unfinished Basement Sq Ft Finished Basement Sq Ft # of Bedrooms # of Full Baths Baths % Baths # Fireplaces ENERGY INFORMATION: (CHECK ONE) ComCheck ❑ UA (Rescheck) ❑ SPA (Simulated Performance ❑ prescriptive❑ ERI(Energy Rating Index) El Alternative) Air Conditioning? YES ❑ NOI City of Fort Collins Approved Stock Plan # SPO List Option #s 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.) For Commercial remodels and tenant finishes, please answer the followine 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): $ 6d, W(]� Description of Work: � /J,}7/v U/a` tsvtL—o /� /�%r �02/ /r 61'uo^/%a $UA)90a? 1/1 WOO)o�F�/LA��;o 7, /� 2 ' 20CV, ©�uG,i sFG �r�h� �x7��vd,``„0 �2nhiJ fi/f� � G✓AGG c�)107 /, .E Sv/y 02ooyvi JOBSITE SUPERVISOR CONTACT INFO: Name 9121�0 m/�Ierj j% Phone 303-&Z�- 78g,7 SUBCONTRACTOR INFO: Electrical Mechanical Plumbing Framing Fireplace Solar 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) ❑ 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 City of Fort Collins ordinances and state laws regulating building construction. Applicant Signature ///�` lii/�/� Type or Print Name 1,52,4,0 ktzV Phone# 3( 3 —5�� Email THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE