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HomeMy WebLinkAbout5609 Falling Water Dr - Applications/Basement Finish - 04/25/2019City of Fort Collins COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES 281 N. College Ave. • Fart Collins, CO 80524 • Phone: 970.416.2740 • www.fcgov.com/building BUILDING PERMIT APPLICATION //''��/] FOR OFFICE USE PPLICATION NUMBER: () No APPLICATION DATE: L4 - 2F,?." Job Site Address S66R RAU-5i,)C WATGD2 :DA- , FctrrC0ttZwsS co 29 Unit# PROPERTY OWNER INFO: (All owner information is required - NOT optional) Last Name First Name (CH Middle C Street Address R _ g 6o`!=.4Zl.Zn�6 WfiiE12 ity Fdle7 CDL- � ,s� State Co Phone#DO-(nEmail c0im Name of Business (COMMERCIAL USE ONLY) A14 Zip ZB. CONTRACTOR INFO: Company Name � License Holder Name LIC # CERT # LEGAL INFO: Subdivision/PUD Filing # Lot # CONSTRUCTION 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 _ Finished Basement Sq Ft /2,?7 # of Bedrooms %Baths %2 Baths # Fireplaces ENERGY INFORMATION: (CHECK ONE) Block # Lot Sq Ft Total Garage Sq. Ft. Bldg Ht # of Dwelling Units Z7Y Unfinished Basement Sq Ft _# of Full Baths 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 ❑ 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 labor): Description of Work: ,ADD — l'Zyd2- OLD koJS�., t r:.tiact.JS APD E-6d?- 35 Ob—uS At A4572*DY ZIJ P)-Ae— JOBSITE SUPERVISOR CONTACT INFO: Name � 1�'(�l H SUS-ryy Vi Phone SUBCONTRACTOR INFO: Electrical Mechanical Plumbing Framing MIA Roofing Fireplace WA Solar eA 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 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 haye read this application and state that the above information is correct and agree to comply with all requirements cQ ain re' nd City of Fort Collins ordinances and state laws regulating building construction. Applicant Signature �� Type or Print Name MZYCR n S'7(L()A4 Phone# q'7Q-6�7'3��% Email 5 UyLVC-JZX19, L-.5—yt . C©M THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE