HomeMy WebLinkAbout4144 S TIMBERLINE RD - APPLICATIONS - 2/28/2008BUILDING PERMITS SL INSPECTIONS DIVISION
P.O. Box 580 •Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER &7 V APPLICATION DATE Old
Job Site Address y/LI V 'i .M —L)✓1 r-- �9 , Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 2ZG
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Last Name (f Ce, he.
t;. 21r7o 'L . L
4 L� Middle
Street Address � Zyy
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1Kizi , City �/ - Z41 /
State c.C/ Zip 0Z
CONTRACTOR INFO:
Naame SleGn✓c-f
i Contractor Phone #
Lic. Holder Name �l
nCompany
riniyyl /�s�"ti City of Fort Collins License # -Z.
Supervisor Cert # s 5 7
Mailing Address
City �� State mil/ Zip7. 1/
LEGAL INFO:
Subdivision/PUD �rJ,�l /� 7 c �- c'� Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq
1st Floor Sq Ft /o-'%00 2nd Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
# of Full Baths
Block # Lot Sq
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
Unfinished Bsmt Sq Ft & b Finished Bsmt Sq Ft %Q 9
% Baths /z Baths L,,&.1 # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or d4a
Type of Heat: P' Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ [��'%,7ex) n
Description of Work: CqzuS-Y-rud'r;- P-'n4+s,L /G% 'N L 74-,_A')k),:.'
4,%'� I, ✓ J /,�j .
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Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical k. Mechanical �H� G2+F'V Plumbing IpC> $ 5
Framer _ Roofing ---- Concrete Other�-
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 o ances and state laws regulating building construction.
Applicant Signature r �� Print Name Phone
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE
Community Planning and Environmental Services
t� Fort Collins Neighborhood & Building Services
C.;ro ni rorcc_ ,bins 281 N. College Ave., P.O. Box 580; Fort Collins, CO 80522-0580; Voice: 970 221 6760 FAX: 970 224 6134
Commercial Construction Application Information
Revised March 6, 2006
Application Number:
Job Site Address: _//`//, In-/; )27 Unit #
New Building Addition Remodel/TF
Name of Business: (f4�6,Ke_ 691rlk �"6) � rlc.s
Proposed Use: (i.e. medical, office, bank, retail, etc)
Project square footage: qO(?
For commercial remodels and tenant finishes, please answer the following:
Is the remodel/tenant finish for an existing tenant or new
tenant? T � /5 k
❑ If for a new tenant, is this the first tenant to occupy this
space?
❑ If not the initial tenant for this unit, what was the previous use of this
tenant space? (If known)
❑ Are there any exterior elevation changes associated with the
work? 4W
Describe:
Sig 'ture
Name (Please print)
�0 -D
Date
Local daytime phone #