HomeMy WebLinkAbout914 S COLLEGE AVE - APPLICATIONS - 1/16/2004F ( a z
BUILDING PERMITS & INSPEcnoNs Dmsm
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P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
City of Fort Collins BUILDING PERMIT APPLICATION
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Last
First
Middle. Phone
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Street Address Please Spec' y: LN. DR. CR. PL. ST CT RD. AVE.
Cit State Zip Code
Company Name License Number
Supervisor & Cert. #
s
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5 5 cp
Mailing Address J
City
State Zip Code
C.D1
Phone
Please Specify. LN. DR, CR, WY PL, IT, CT, RD, AVE. Zip Code
Subdivision/PUD � O/o� q
�� - �-7132 -z� -cxny
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Filing Number
Lot Block
Lot Area
Z9
Building Square Footage
IR52
Number of Stories
Building Height
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Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
VJ
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Stock Plan Number/Options
Radon
Energy Score/ E-Star/Air Sealing/Blower Door
Y/N
y
Water Tap Size
Sewer Tap Size
Metered
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Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
❑ Gas ❑ Electric
❑ 150 amp or less ❑ 200 amp ❑ other
❑ Yes ❑ No
�M (including labor, material, profit) $ �j3-5Xo , pD
Description of Work: s , D 1, e al
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Ob Contact Name & Phone #: v�a& --L!1g3 b
Subcontractor Names:
Electrical �� c,� Mechanical
Framer
Roofing
_ Plumbing t.azim-i
Concrete 77 M
II 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 ordinances and state laws regulating building construction.
a Signature
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Print Name U rl S li)e sS eL5 (2pWY allOTPhone a a to
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
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Commercial Construction Application Information
Revised May 10, 2000
Application Number:_
Job Site Address: '71q S ��� ����� A,t - Unit #
New Building :dd:itio Remodel F.
Name of Business: bf-4 lj)e4--P—rn (t,r, , U e ro 1 0
Proposed Use:,(i.e. medical, office, bank, retail, etc) rn01-ed
Project square footage: 19 5 Z
For commercial remodels and tenant finishes, please answer the following:
Is the remodel/tenant finish for an existing tenant or new
tenant? ua�q
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If for a new tenant, is this the first tenant to occupy this
space?
o If.. not the initial tenant for this unit, what was the previous use of this
tenant space? (If known)
ex Are there any exterior elevati
work? , ,,y Jo
Describe: -
Signature I �
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444zName (Please print)
than es'associated with the
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Date
Otis &
Local daytime phone #
281 North College Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134