HomeMy WebLinkAbout2550 Stover St - Applications/Tenant Finish - 10/11/2019r'
Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416.2740 • www.fcgov.com/building
BUILDING PERMIT APPLICATION
FOR OFFICE USE
APPLICATION NUMBER: P R5474 APPLICATION DATE: to
Job Site Address Z6-5a 5 f-ay &Z P Cr /f Unit#
PROPERTY OWNER INFO: (All owner information is required - NOT optional)
Last Name ko e1� K7-jq First Name
Street Address 3V&g TzAZe CpK City
Phone # Email y e
t is
►�iR•l:lt�
F"a 7- 60tZ-i.cJg State e-o Zip R053,5-
9de7LseY✓/'c2S ,f;W e; met /. esz�vh
Name of Business (COMMERCIAL USE ONLY) INS p`rowA) V&r466Q.AAJ6V Ce;t.(gElL
CONTRACTOR INFO: Company Name LJEST6rt�! �o.v?+zuCT�a6J IYIGr�,.v�
License Holder Name STG c (2Art/20Z')r_ LIC# CERT#
LEGALINFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) Total Garage Sq. Ft. J114
Residential Sq Ft JtiA Commercial Sq Ft 331�Z'� # of Stories Bldg Ht # of Dwelling Units_
1st Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft Unfinished Basement Sq Ft Ale4
Finished Basement Sq Ft �IA # of Bedrooms 0 # of Full Baths O
Baths a % Baths ' # Fireplaces
ENERGY INFORMATION: (CHECK ONE)
ComCheck ❑ UA (ResCheck) El SPA(Simulated Performance ❑ Prescriptive❑ ERI(Energy Rating Index) ElAlternative)
Air Conditioning? YES ❑ NO ❑
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.) (��Tzvc,iuArri CG/ n1/C
Is the remodel/tenant finishes for an existing or new tenant? (Please check one)
Existing Tenant❑ New Tenantjg
If for a new tenant, is this the first tenant to occupy this space?
Yes 1K No a If not for the initial tenant for this unit, what was the previous use of this tenant space?
1`STs,u'Vove �/ I'c./ a> > c 054
Are there any exterior building changes.(including mechanical) associated with the work? Yes ❑ No (�
If yes, please describe:
f
Value of Construction (materials and labor): $ /� Q, d'2�0
Description of Work: x pd? Z-- (z B,d-i' W—W Fz6o,2�-,W67
f' 1fA vas L/!LAAT)ti 6,
10BSITE SUPERVISOR CONTACT INFO: Name /3AcvcE JOIAX"61-dy Phone 9 70- 2! f-- t/6
SUBCONTRACTOR INFO: Electrical (Alin! TES r1 -'/< 91FCTn)o Mechanical /1)0 /UE
Plumbing J, ¢ 7 ,z>c) �L wi s6- Framing A/ & Roofing %VJ4
Fireplace /V .4 Solar /✓0 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 1 have read this application and state that the above information is correct and agree to
comply with all requirements co tained herein and City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature ' Type or Print Name�� �,St,z2 rc
Phone# %70- Z27-- 7S-s-a Email 5-,C�cYr,�e.S2C�gr
THIS APPLICATION EXPIRES 280 DAYS FROM APPLICATION DATE