HomeMy WebLinkAbout1208 W Elizabeth St - Applications/Addition or Alteration - 03/19/2019Flirt Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416.2740 • www.fcgov.com/building
BUILDING PERMIT APPLICATION
r�, I1 FOR OFFICE USE
�A G I ID APPLICATION DATE: 3 119
I
APPLICATION NUMBER: V �R
Job Site Address 1208 W ELIZABETH ST. Unit#
PROPERTY OWNER INFO: (All owner information is required — NOT optional)
Last Name LAUDERDALE First Name RICHARD Middle
Street Address 999 SOUTH SHADY GROVE RD, SUITE 600 City MEMPH IS State _Zip 38120
Phone # (901) 259-2500 Email richard IauderdaleCa�areystar.com
Name of Business (COMMERCIAL USE ONLY) GREYSTAR
CONTRACTOR INFO: Company Name Dohn Construction Inc
License Holder Name Douglas Dohn LIC# B-198 CERT#
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) Total Garage Sq. Ft.
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
Baths % Baths _
ENERGY INFORMATION: (CHECK ONE)
ComCheck ❑ UA (ResCheck) ❑
# of Bedrooms # of Full Baths
# Fireplaces
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): 1SO 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): $ $22,550
Description of Work: THREE FIRE FEATURES AND TWO OUTDOOR GRILLS
N
JOBSITE SUPERVISOR CONTACT INFO: Name Ron Shimpa Phone 970-566-0262
SUBCONTRACTOR INFO: Electrical
Bret's Electric
Plumbing Linds Plumbing Framing
Mechanical Air Comfort
Roofing
Fireplace Solar other Diamond TTSpas and
ra
ASBESTOS STATEMENT DISCLOSURE: In accordance with the State of Colorado Senate Bill 13-152,1x5TM%rldrgr4�1ying for a
remodel permit, shall indicate their awareness about their property having been inspected forAsbestos Containing Materials (RCM's).
Im
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 contair of Fort Collins ordinances and state laws regulating building construction.
Applicant Signat e/ Type or Print Name Jennifer Chavies
Phone # 9 0 -0895 Email jchavies@dohnconstruction.com
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE