Loading...
HomeMy WebLinkAbout2631 Pampas Dr - Applications/Addition or Alteration - 09/17/2020City of Fart 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: 1�2_k,�O&ft APPLICATION DATE: 9— l % — Z.vz 6 Job Site Address -63 ( /� Unit# PROPERTY OWNER INFO: (All owner information is required — NOT optional) Last Names ���„ First Name Middle Street Address 2.63/ l�Q�pAs Dl- City f / State Cy Zip OS'Zc Phone# 7_�2_-2411_S-q/ Email Name of Business (COMMERCIAL USE ONLY) CONTRACTOR INFO: Company Name License Holder Name rle° zooI LIC#C/ w3 CERT#y77S-c/ JAR LEGAL INFO: Subdivision/PUD Filing # Lot # Block # Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (NOT including basement) _f //// Total Garage Sq. Ft. So C) Residential Sq Ft2-2q' / Commercial Sq Ft # of Stories Bldg Ht # of Dwelling Units 1st Floor Sq Ft/4/ // 2nd Floor Sq Ft 3rd Floor Sq Ft Unfinished Basement Sq Ft Finished Basement Sq Ft e6O # of Bedrooms 4# 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 0 Electric 0 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.) P_e5) CIP_m`) Wa For Commercial remodels and tenant finishes. please answer the following auestions: 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 IT If yes, please describe: Value of Construction (materials and labor): Description of Work: RAPA)rs kue -74 4 Z�.-- �9/� d G✓Jrl n c, o n� /yJ.n -L 4-P J r eS �A� csr i1 c d JOBSITE SUPERVISOR CONTACT INFO: Name / Zvi ! Phone 720 SUBCONTRACTOR INFO: Electrical Jh fj Mechanical Plumbing Framing Z?���evRoofing �E' o/— 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 re is application and state that the above information is correct and agree to comply with all requirements contained here d City of Fort Collins ordinances and state laws regulating building construction. Applicant Signature /` Type or Print Name 011<e Phone # ZO . 27 — $' Email %/%J& m Si>7i f (%�� j� C d THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE