HomeMy WebLinkAbout4700 BOARDWALK DR - APPLICATIONS - 10/21/2015Fort Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. - Fort Collins, CO 80524 - Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 6I60OA03 APPLICATION DATE O — 16 1 - 1-4-16
Job Site Address
4700 Boardwalk Drive Unit #
PROPERTY OWNER INFO: (All owner information is required— it is not optional) Phone
Last name Sam's West Inc. First Name
Street Address PO Box 8050 city Bentonville
CONTRACTOR INFO: Company Name
Lic Holder Name
:M
Middle
Contractor Phone #
State AR Zip 72716
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 N/A
Residential Sq Ft N/A
15' Floor Sq Ft
Comm'I Sq Ft 654 affected # of Stories Bldg Height # Dwelling Units N/A
2nd Floor Sq Ft
3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/ Baths # of Fireplaces
Air Conditioning: YerNon Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door 11
4. Simulated Performance Alternative❑ 5. Prescriptive w/Air Sealing11 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes ❑No[] Temp. Pedestal Yes No El
Type of Heat: nGas Electric Electric Main Breaker Size (Residential only) F-1150 Amp or Less 11 200 Amp DOther
Value of Construction (including labor, material & profit) It 3,500.00
Description of Work:
Adding two self contained refrigerated cases to customer pick up area
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: TBD
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 �� Print Name Derek Dague, permit coordinator Phone 479-878-3524
Distribution: White —Office Yellow —Applicant Pink —WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City Of Planning, Development and Transportation
Fort Collins PO Box 580
/ 281 N College Ave
Ft Collins, CO 80524
970-2-21-6760 phone 970-224-6134fax
Commercial. Construction Application Information
ReVis d',03/_3Q/2009
Application Number. P
Job Site Address:
4700 Boardwalk Drive
New Building Addition Remodel/TF x
Building owner:
Sam's West Inc.
Building owner address:
Building owner phone M
PO Box 8050, Bentonville, AR 72716-0555
479-878-3524 (contact/applicant - Derek Dague,. permit coordinator)
Name of Business: ' Sam's Club #6633
Proposed Use: (i.e. medical, office, bank, retail, etc)
Project square footage:
645 square feet
mercantile (existing use)
For commercial remodels Et tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an (please circle answer)
existing tenan 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? N/A
➢ Are there any exterior building changes associated with the work? Yes or No
If yes, please describe: N/A
Signature of applicant Date
Derek Dague, permit coordinator, applicant
Name (please print)
479-878-3524
Local daytime phone #