HomeMy WebLinkAbout821 Peterson St - Applications/Patio Cover or Sunshade - 04/11/2019City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. •Fort Collins, CO 80524 •Phone: 970.416.2740 • www.fcgov.com/building
BUILDING PERMIT APPLICATION
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4PPLICATION NUMBER: '�`/\/ S U �{�11� el` APPLICATION DATE: ® I
Job Site Address pe }G(Sof, 5+• r0j fi Rio (+fl :� ��/� c� Unit#
PROPERTY OWNER INFO: (All owner information is required — NOT optional)
Last Name Gze('wor, N4 First Name Too Middle
Street Address � r- I LP&+t ('50 City Foi + tate (v Zip 0 Cq(
Phone #Ooa)6h-Dy37, Email },m �i,��pad560 ai' C-0M
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company 1Name 6P, Lpl1 j�'i (�(i+i0�l
License Holder Name 0"y Ir-5 1 ) � fi G/j- 5 LIC # CERT #
LEGAL INFO:
Subdivision/PUD Filing # Lot #
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement)
Residential Sq Ft 351D Commercial Sq Ft # of Stories_
1st Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft
Finished Basement Sq Ft
# of Bedrooms
Baths % Baths # Fireplaces
ENGERGY INFORMATION: (CHECK ONE)
Block # Lot Sq Ft
Total Garage Sq. Ft.
Bldg Ht # of Dwelling Units
Unfinished Basement Sq Ft
# of Full Baths
(Simulated Performance
ComCheck ElUA (ResCheck) El SPA Alternative) ❑ Prescrlptive❑ ERI(Energy Rating Index) El
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:
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JOBSITE SUPERVISOR CONTACT INFO: Name Aa ran WeSth(A i s Phone 7p) S76
SUBCONTRACTOR INFO: Electrical
Plumbing
Fireplace
Mechanical
Framing Roofing
Solar 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 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 NQ 0 0 L✓�i5� l� 1 5
Phone# LqZ> 57G — b t-}a Email Icarpo fga bod -�•Com
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE