HomeMy WebLinkAbout1320 Forrestal Dr - Applications/Basement Finish - 05/01/2019City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Flirt Collins
281 N. College Ave. •Fort Collins, CO 80524 • Phone: 970.416.2740 • www.fceov.com/buildine
^BUILDING PERMIT APPLICATION S 191
jj�FOR OFFICE USE
PPLICATION NUMBER: ° APPLICATION DATE:
Job Site Address 132,9 pZc.5r.,4Z )t?zi m ff 6ou> LP 4p65 Unit#
PROPERTY OWNER INFO: (All owner information is required — NOT optional
Last Name At-(WZHe5- First Name Middle
Street Address ' �eA' City State Zip
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Phone # ��Q— `7uo=.3! x 2eo Email
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Co pany Name
License Holder Name �/r15>�/�,�r�>t/
LIC #
—(n/_� CERT #—(�
LEGAL INFO:
Subdivision/PUD Filing # Lot #
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement)
Residential Sq Ft Commercial Sq Ft # of Stories
1st Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft
Block # Lot Sq Ft
Total Garage Sq. Ft.
Bldg Ht # of Dwelling Units
Unfinished Basement Sq Ft
Finished Basement Sq Ft ss— # of Bedrooms �2=,# of Full Baths
Baths Y2 Baths # Fireplaces
ENGERGY INFORMATION: (CHECK ONE)
ComCheck ❑ UA (ResCheck) ❑ SPA (Simulated Performance ❑ Prescriptive❑
Alternative)
Air Conditioning? YES ❑ NO ❑
City of Fort Collins Approved Stock Plan # SPO List Option #s
UTILITIES INFO: Gas ❑ Electric ❑ Electric Temp. Pedestal Yes
Electric Main Breaker Size (Residential Only): 150 amp or less ❑ 200 Amp
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)
ERI(Energy Rating Index) ❑
❑ No ❑
❑ Other ❑
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):
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Description of Work:
JOBSITE SUPERVISOR CONTACT INFO: Name f/Q/ Phone
SUBCONTRACTOR INFO: Electrical r 1,1,7-Xlll ZI,& Mechanical
Plumbing z lj�r �h//, Framing ��jj5 /iYf Tyry Roofing �—
Fireplace -C Solar Other
ASBESTOS -STATEMENT DISCLOSURE: In accordance with the State of Colorado Senate Bill 13-152, property owners, applying for a
remod permit shall indicate their awareness about their property having been inspected for Asbestos 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 requiremenJO contained herein and City ins ordinances and state laws regulating building construction.
Applicant Signature v Type or Print Name Lkx,Saox_wlla � T Phone # � _� G Email �, ig yy� fi/rpL1o�Z,lo� / W � qzZ&
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE