HomeMy WebLinkAbout5609 Big Canyon Dr - Applications/Basement Finish - 07/16/2019City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F\rt Collins
281 N. College Ave. •Fort Collins, CO 80524 •Phone: 970.416.2740 • www.fcaov.com/buildine
BUILDING PERMIT APPLICATION
1,06 gOpm�/j. 5 FOR OFFICE USE P
APPLICATION NUMBER: I /"Iv/VVVF///7//,/(�',l APPLICATION DATE: � ' ` 0 - L
Job Site Address 6M giq CIWV(brl Dr -
PROPERTY OWNER INFO: All owner info mation is required — NOT optional)
Last Name Odom First Name
Street Address wq P71 anUh Dr City
Phone # t1�1Lqll-.% Email DAI
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name
License Holder Name
Unit#
Mj6MI& Middle Pheree
a ro 146 State _ p—Zip 00
LIC # CERT #
LEGAL INFO:
Subdivision/PUD M(-(If jjg'nk Creek Filing # 3r4 Lot # Block # Lot Sq Ft
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) 2?P 2. Total Garage Sq. Ft. —72,(o
Residential Sq Ft ZM2. Commercial Sq Ft # of Stories 2, Bldg Ht # of Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft Unfinished Basement Sq Ft DD
Finished Basement Sq Ft 0143 # of Bedrooms # of Full Baths �
% Baths —' % Baths # Fireplaces
ENERGY INFORMATION: (CHECK ONE)
ComCheCk El UA (ResCheck) El SPA(Simulated Performance ❑ Prescriptive[]ERI(Energy Rating Index) ❑
Alternative)
Air Conditioning? YES 0 NO ❑
City of Fort Collins Approved Stock Plan # SPO
List Option #s
UTILITIES INFO: Gas M Electric ❑ Electric Temp. Pedestal Yes ❑ No ❑
Electric Main Breaker Size (Residential Only): 150 amp or less 0 200 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 �I
If yes, please describe:
Value of Construction (materials and labor):
Description of Work:
JOBSITE SUPERVISOR CONTACT INFO: Name ilia l , um Phone/ M10 , rv$I .Ih VI
— SUBCONTRACTOR INFO: Electrical Mechanical l,GclT
Plumbing Framing Roofing Fi
Fireplace N A� Solar tZA: 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).
❑ 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
Phone # 6-Tj0. `+j2 - 2,L[?L( Email
Type or Print Name Mi Ghellle Ode m
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE