HomeMy WebLinkAbout1913 Yorktown Ct - Applications/Basement Finish - 07/15/2019�t of
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 470.416.2740 • www.fcgov.com/building
BUILDING PERMIT APPLICATION
100 (
( FOR OFFICE USE a
APPLICATION NUMBER: B l `'(�, L � S I ul APPLICATION DATE: � � I
Job Site Address `O' 1"?) \)OCRV-- oWn C± I -po,.V C.OI46S CO Unit#
PROPERTY OWNER INFO: All owner information is required— NOT optional) lz f "
Last Name S 1 2Al Y First Name Car
` A Middle
1" \CL�'G1 t, � t
Street Address ig r V1DyV---tWn C:k- City Epxt CU) < i y, S State C ) Zip .gyp
Phone # —C�A4O Email
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name
License Holder Name
LIC # CERT #
LEGAL INFO:
Subdivision/PUD Filing # �j o Lot # _Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (NOT including basement) (C�) QC) 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 50-7
Finished Basement Sq Ft S cT] # of Bedrooms ( # of Full Baths �
Baths I Y2 Baths Q # Fireplaces O
ENERGY INFORMATION. (CHECK ONE)
ComCheck El UA (ResCheck) El 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 Q Electric Temp. Pedestal Yes ❑ No ❑
Electric Main Breaker Size (Residential Only): 150 amp or less S-� 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): $ �'o I p0 0
Description of Work:
JOBSITE SUPERVISOR CONTACT INFO: Name
SUBCONTRACTOR INFO: Electrical
Plumbing
Fireplace
Framing
Solar
Phone,
Mechanical
Roofing'
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).
B 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 Fdrt Collins ordinances and state laws regulating building construction.
Applicant Signatur Type or Print Name Yy-� Our CAa R Q_t
Phone# � Q3— ` �Q�-C'J��C7 mail IMac0�1-Q ko 0,(E I rnav royr
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE