HomeMy WebLinkAbout424 PINE ST - APPLICATIONS - 3/21/2008BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
66 www.fcgov.com/building
CityofFortCollins BUILDING PERMIT APPLICATION
APPLICATION NUMBER w &U I L 4 — APPLICATION DATE '3 Z 011
Job Site Address � 2,-I 2", 54ruk Sty � 100 Unit #
PROPERTY OWNER INFO: (All owner information is required - it isnotoptional) Phone # Q%b - k13 - Z(, 2-&
oe Last Name L C/ eJ First Name . All /IL Middle /0,
Street Address S�rt't-x f�In Uy City { v ri Co( I,�S State o Zip SOS Z-y
CONTRACTOR INFO: Company Name -pUtnvt Contractor Phone # g �o - Y y0 - IZ'5 5
Lic. Holder Name,D O1 �`S S •�o� ti City of Fort Collins License # Supervisor Cert #
No Mailing Address yc�
2 �� kJrivc- City I,r{ (o11ihS State t�'0 Zip T5O5Z5
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq
N
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft I
Residential Sq Ft
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes
3. ResCheck w/Blower Door
Comm] Sq Ft # of Stories I Bldg Height # Dwelling Units 4
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths 3/4 Baths '/ Baths
No Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
City of Fort Collins Stock Plan #
List appropriate option #s
# of Fireplaces t.
- o
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
!,I s@
Value of Construction (including labor, material & profit) $ ' 13, 303
of Work: tt�
r
0
M
m
Fo C' � odd' Ler ru o %. n ne cm
in ec ch room. It.ew w.N AIS1
Contact Name & Phone # of JOBSITE SUPERVISOR: �jriGn GaSS a�� - 56G - 2a�3
Subcontractor Info:
-'r MechanicalI3Electrical t Plumbing 1 9I%
� U Framer > Roofing NA Concrete P/A 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 ordinances and state laws regulating building constrruuction.
Applicant Signature +Yr ' _l Print Name etf f mel Phone
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE
Community Planning and Environmental Services
Building and Zoning Department
City of Fort Collins
Commercial Construction Application Information
Revised May 10, 2000
Application Number
MW
1742
Job Site Address: qZy R^� SirLp-� Unit #
New Building Addition Remodel/TF
Name of Business: �kv`; Ve'rj y G"� ��.
Proposed Use: (i.e. medical, office, bank, retail, etc) Ckc I C5„`
Project square footage:
For commercial remodels and tenant finishes, please answer the following:
o Is the remodel/tenant finish for an existing tenant or new
tenant? �%Uen'f
❑ If for a new
space? --- CI
nant, is this the first tenant to occupy this
❑ If not the initial tenant for this unit, what was the previous use of this
tenant space? (If known) N&
❑ Are there any exterior elevation changes associated with the
work? IJ 0
Describe:
2o2 9 /IR
Signature Date
1VQP J'rd0-f%e-1 . 9?o-SG(>-2`l36 97c)-5`9�-/Sss
Name (Please print) Local daytime phone #
281 North College Avenue • PO. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134