HomeMy WebLinkAbout1800 E Prospect Rd - Applications/Addition or Alteration - 06/25/2019City of
FOrt C®«Ins, COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
/"��• 281 N.'Cdllege Ave. 4i Fort Collins, CO 80524 • Phone: 06.416.2740 www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER: A9644p1 FOR OFFICE USE
APPLICATION DATE:
Job Site Address I�� �. ��.� Unit#
PROPERTY OWNER INFO: (All owner information is required — NOT optional)
Last Name 5tqt*%-First Name Middle
Street Address '11bw IE, !L&t'r City (� �i 6, -r ZQM.A.,.2t ` State Zip
Phone # 111a i Email �6��VS�1�n a�,l� • `�\ , ®�
Name of Business (COMMERCIAL Use ONLY)
CONTRACTOR INFO: Company Name
License Holder Name Z 6CA aLIC # • yZ CERT # Z77 1-8
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) •(!�F- Total Garage Sq. Ft.
Residential Sq Ft Commercial Sq Ft. # of Stories Bldg Ht # of Dwelling Units
1st Floor Sq Ft 2 n d' Floor Sq Ft 3rd Floor Sq Ft Unfinished Basement Sq Ft
Finished Basement Sq Ft
Baths % Baths _
ENERGY INFORMATION: (CHECK ONE)
ComCheck ❑ UA (ResCheck) ❑
Air Conditioning? YES ❑
# of Bedrooms
# Fireplaces
SPA (Simulated Performance ❑
Alternative)
NO ❑
# of Full Baths
Prescriptive❑ ERI(Energy Rating Index) ❑
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 (A
If yes, please describe:
Value of Construction (materials and laborl, $ Z,zo,-
Description ofWork: 1OWCAV-LAVION or Srre lr tawrsv-� '!:gYb-rB,,uA pQu-
JOBSITE SUPERVISOR CONTACT INFO: Name .ACM + %*.V.g Phone ,�11p- Imtft- taSS(
SUBCONTRACTOR INFO: (( Electrical OA rQ 4,CLe t%,eMA,,,C, Mechanical (� � A
Plumbing k`A Framing k14 Roofing 1AA
Fireplace Nf A Solar Alta Other WA
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 for Asbestos Containing Materials (AWS).
WdeI 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 Type or Print Name '36AW t069AS
Phone # ���- SV i$Z J Email c-o� er5 k I, aeon I+iaS'� Cc1�
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City/ of Planning, Development and Transportation
Fort
Collins PO Box 580
281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134fax
Commercial Construction Application Information
Revised 03/3012009
Application Number:
=I
Job Site Address: 11,�M E. '1 MzPrtVr "N
Slt�.
New Building Addition Remodel/TF k ���aarcA
Building owner: _ t�JE•�E��. �. �.lrleci�_
Building owner address: l fbtb Chmma tu, V..
Building owner phone #: Q?o- q tr1-%57
Name of Business: 5r'14C'tL
Proposed Use: (i.e. medical, office, bank, retail, etc) "�Li%�mE ��1.
Project square footage: A'
For commercial remodels It tenant finishes, please answer the following questions:
➢ Is the remo 'nishes for an (please circle answer)
existing tenanV or new tenant?
➢ If for a new tenant, is this the first tenant to occupy this space? Yes or No
➢ if not the initial tenant for this unit, what was the previous use of this tenant
Space?
➢ Are there any exterior building changes associated with the work? Yes
If yes, please describe:
Sign tur of applic nt
`JEA.Q E25
Name (please print)
or No
l��t®�zoa9
Date
970-��� - « t
Local daytime phone #