HomeMy WebLinkAbout2615 Eagle Roost Pl - Applications/Basement Finish - 05/15/2019City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. •Fort Collins, CO 80524 •Phone: 970.416.2740 • www.fceov.com/building
BUILDING PERMIT APPLICATION
`` FOR OFFICE u"
APPLICATION NUMBER: APPLICATION DATE:
Job Site Address 1" 1 owteF-PvQ5r
PROPERTY OWNER INFO: (All owner information
S.
required — NOT optional)
Unit#
Last Name G-LA-S&DKI First Name Vol LM P Middle
Street Address 2t016 EAlai.6 P9oS'r City fVJTWLaAWS State CJO Zip 6052$
Phone# qlo-Zloi—sa?I - Email
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name
License Holder Name'jyLA(,py'L LIC #L-piCERT #
LEGAL INFO:
Subdivision/PUD FAIyA Filing # 2- Lot # Block # $
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
Finished Basement Sq Ft t41 S # of Bedrooms Z
Lot Sq Ft 11, (,-11
Total Garage Sq. Ft.
Bldg Ht # of Dwelling Units
_Unfinished Basement Sq Ft_
# of Full Baths I
Baths 1& Y, Baths # Fireplaces .er�
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 ❑ 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:
r
Value of Construction (materials and labor):
Description of Work: f7jVljSl} ( PPp g,~5; 6411F lA4INfraDM/) 00 Le1SE
JOBSITE SUPERVISOR CONTACT INFO: Name yloele�' w 1-WA 1(k&V-- Phone 170 a101` Iq
SUBCONTRACTOR INFO: Electrical AI/V1 .(,Qp,)N & Mechanical u IA -
Plumbing 64e!Fs� bY0*0%5 Framing CADMA w�A Roofing
Fireplace (CIA- Solar N1i Other
N
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 requirem"'l- 'ne he ein and City of Fort Collins ordinances and state laws regulatingbuilding construction.
Applicant Signature Type or Print Name �Re.—y
� "'rl
Phone # Email OS
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE