HomeMy WebLinkAbout3418 Stratton St - Applications/Basement Finish - 06/18/20190
City of
Flirt Collins COMMUNITY DEVELOPMENT &NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80S24 • Phone: 970.416.2740 • www.fcgov.com/building
BUILDING PERMIT APPLICATION
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FOR OFFICE USE
PPLICATION NUMBER: I 04�>OD APPLICATION DATE:
Job Site Address S y�h' �j�/,f %,/il /,,/- I-o,
PROPERTY OWNER INFO: (All owner'ififormMion is required — NOT o
Last Name/�j�� First Name S
Street Address 3�%/� ,, r� City
Phone # may/—_,f '<;K, 37 Email
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: CTnt)
y Name / /
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License Holder Name
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
Finished Basement Sq Ft # of Bedrooms
% Baths Y2 Baths # Fireplaces
ENGERGY INFORMATION: (CHECK ONE)
(' Unit#
2
Middle ?pI, y
_State CD Zip
LIC # CERT #
Block # Lot Sq Ft
Total Garage Sq. Ft.
Bldg Ht # of Dwelling Units
Unfinished Basement Sq Ft
—
# of Full Baths
ComCheck El UA (ResCheck) El SPA(Simulated Performance ❑ Prescriptive❑
Alternative)
Air Conditioning? YES ❑ NO ❑
City of Fort Collins Approved Stock Plan # SPO List Option #s
ERI(Energy Rating Index) ❑
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 auestions:
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:
It l C/fit/ `- )
JOBSITE SUPERVISOR CONTACT INFO: Name Phone
SUBCONTRACTOR INFO: Electrical y� . y� Mechanical Q 1�
Plumbing6 y-Framing Roofing
Fireplace 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 forAsbestos Containing Materials (ACM's).
IS
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
Phone #
Type or Print Name
Email
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
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