HomeMy WebLinkAbout114 N COLLEGE AVE - APPLICATIONS - 1/25/2011F6rt
Cityof COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Collins 281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
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Job Site Address Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 17� - 2 o 5/ov � �T�rk IJP� 5 j
Last name NX I nl ev First Name Middle
Street Address 3 7// TF�L %�_ �l�u-�.y City l=/ , State C a Zip rr OS Z s-
CONTRACTOR INFO: Company Name Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Comm'I Sq Ft # of Stories Bldg Height # Dwelli
15t Floor Sq Ft 2"d Floor Sq Ft 3'' Floor S F Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # aths 3/4 Baths 1/2Baths # of Fireplaces
Air Conditioning: Yes No info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blowe 4. Simulat Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
ort Collins Stock Plan #
UTILITIES INFO:
List appropriate option #s
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
Value of Construction (including labor, material & profit) $ 14 ?D a o
Description of Work: % Ch ✓twn %i,1/;4 -Zvr c L "/1 "5 a old ins � ro-) 1OQ4 e11"eit /- S7/4k/
Contact Name & Phone # of JOBSITE SUPERVISOR: 41 ✓! e-o-r-/ Sk
Subcontractor Info: /
Electrical �lrr7'f �C�tc�r�c Mechanical
Framer
Solar
Roofing
Other
Concrete
Other
Plumbing 4 1614ej
Fireplace
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 construction.
Applicant Signature Print Name Phone
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Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City of Planning, Development and Transportation
Flirt Collins PO Box 580
% ® 281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134fax
Commercial Construction Application Information
Revised 03/30/2009
Application Number:
Job Site Address:
New Building
MIMI =M.,
Addition
Building owner:
Remodel/TF
Building owner address: / / V A/V -I-A -�"a /i,-ye- X-t-
Building owner phone #: 9 7 v - Qo - 4,Y9Y
Name of Business: e;PVn D/,,,�
Proposed Use: (i.e. medical, office, bank, .tail tc)
Project square footage:
/ Z Z-1,
For commercial remodels Er tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an clrc answer)
existing tenant or new tenant?
➢ If for a new tenant, is this the first tenant to occupy this space? Yes or No
➢ If not the initial
Space?
nt for this unit, what was the previous use of this tenant
➢ Are there any exterior building changes associated with the work? Yes
If yes, please describe:
Q�
Signature of ap icant
Name (please print)
Date
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Local daytime phone #