HomeMy WebLinkAbout1422 N COLLEGE AVE - APPLICATIONS - 10/16/2015City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER v I `� APPLICATION DATE
Job Site Address Unit #
PROPERTY fOWNER INFO: (All owner information is required - it is not optional) +hum-*- F // o r 00'4m
Last name First Name Middle
n /1 I
Street Address �� (.� n_� . (�y 1 I C� ity 'Cl n 1 i n s State619 Zipf1Q TQq
CONTRACTOR INFO: Company Name Contractor Phone #
rn/-'
Lic Holder Name (� n '/L� `` City of Fort Coll s License #s Supervisor Cart #
Mailing Address_3 D � &I? S�l1 f tT City76r4 4/)i1/1 S State Zip
LEGAL INFO:
Subdivision/PUD
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq
15' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
Filing # Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/, Baths /z Baths # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort 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 8 profit) $ (CY /7, 5&-) 15:1
Description of Work:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
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_. lr Print Name �C/�C�C f��Phone r �,
Distribution te—Office Yellow —Applicant Pink—WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
Fort of
Commercial
Application Number:
Job Site Address:
New Building
Building owner:
Building owner z
Planning, Development and Transportation
PO Box 580
281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134 fax
Construction Application Information
Revise) 03/.3012009 l ,
y
u
Addition Remodel/TF
Building owner phone #: V / 0 0 OLLD
Name of Business:
Proposed Use: (i.e. medical, office, bank, retail, etc) C -P _S4 `zinl.l a n 4
Project square footage:
� S
For commercial remodels Ft tenant finishes,'
answer the following questions:
➢ Is the remodelltenant f n-1 hes for an (please circle answer)
existing tenar or new tenant?
➢ If for a new tenant, is this the first tenant to occupy this space? Yes or No
➢ If not the initial tenant for this unit, what was the previous use of this tenant
Space?
➢ Are there any exterior building changes associated with the work? Yes orONo
If yes, please describe:
Signature f applicant )
SCi r�\J a -�al 0
Name (ple se print)
f6-
Date
LIZ q- iI� tig
Local daytime phone #