HomeMy WebLinkAbout2121 Chandler St - Applications/Deck - 08/20/2020City - COMMUNITY DEVELOPMENT_& NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416.2740 . www.fcgoJ.com/building
BUILDING PERMIT APPLICATION
B2009455 FOR OFFICE USE 8/20/2020
APPLICATION NUMBER: APPLICATION DATE:
Job Site Address ()J cJ,J
PROPERTY OWNER INFO: (All owrier
is required - NOT optional)
`Unit#
Last Name 4--ih,7 First Name (3reff Middle
Street Address al l <:%,4d(dr� Qr- City CorState C.0 Zip
Phone# Q?D �, � - 11113 Email `xf,-tMrYzk AOTlnai!-cor
Name of Business (COMMERCIAL Use ONLY) .:
CONTRACTOR INFO: Company Name Ike- �i✓iS7l juC, ro fAC_
OR License Holder Name eoA RC4/11/j e, LIC # CERT #
LEGAL INFO:
Subdivision/PUP Filing # Lot # Block # : Lot Sq Ft
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) 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
Finished Basement Sq Ft # of Bedrooms # of Full Baths
% Baths %= Baths # Fireplaces
ENERGY INFORMATION: (CHECK ONE)
ComCheck ❑ UA (Rescheck) ❑ 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 ❑ 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 El 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:
instruction (materials and labor): $
i of work: /cMou-e- old '' leak 1
Sad
�- • i� i fti �jety, ,SaI� S 12c-
3Do SF, 61,40srf-- Dee-4,4�- rAdf-)�, Plan fo use- old 6Kt31'A5, e'onc-vck 6zf-1
�.SSOn.S
JOBSITESUPERVISORCONTACTINFO: Name �c3co6�/lenv+in�er Phone
SUBCONTRACTORINK: rical Mechanical
Plumbing ng 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).
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 Type or Print Name 1 Z/aCp/1r%1�' er
Phone # T%D - �3 o S— gyp$ G Email Ac66, C 00(j %ok-(nnM
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
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