HomeMy WebLinkAbout114 BRISTLECONE DR - APPLICATIONS - 4/5/2016 (8)City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740.
wvvw.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER `0� `l' O I� APPLICATION DATE —I `
Job Site Address
PROPERTY OWNER INFO: (All owner information is required - It is not optional)
Phone
Last nam2't-tfli i=j-�L�f,ri II First Name V�1[e
Unit #
9
Street Address 10 2-Lil . '_�; 1 O AW . City a1' � l�J III o S StateyZipt9n 5?_ y
CONTRACTOR INFO::Company Name tRair 2 C.;12/ 51 d't/ �v fir? L Contractor Phone # q 70 554, - 5& 4Z
Lic Holder Name l Gtrit✓i 2 1 Q P rf` City of Fort Collins License # ` .33 & Supervisor Cert # ZOZ - 5
Mailing Address % f! �� $� ✓,�/1 G{ i° CityajyeleState Zip &2& 3
LEGAL INFO:
Subdivision/PUD �V CL_U& �,'fitUA:! 1 -S DUB Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 171.0 Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft 9- 72.0 1 # of Stories_ Bldg Height # Dwelling Units
15' Floor Sq Ft
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: Y I0o�
Energy info: ( Circle appropriate choice ) 1. ComCheck11 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door
❑
4. Simulated Performance Alternative
5. Prescriptive w/Air Sealing11
6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option #s
UTILITIES INFO:
Water Tap Size l AOC�Sewer Tap Size Metered: Yes �]Noo Temp. Pedestal Yes❑ No ❑
Type of Heat: 1� Gas ❑Electric Electric Main Breaker Size (Residential only) F-1150 Amp or Less ❑ 200 Amp DOther
Value of Construction (including labor, material & profit) $ Z 0 O� 000
Description of
ME-k) Wiq
'PU /' //" VK- 0VEYg4 r=A,— / o f /(--- P-U/LA iA/r- _ ��oW 'Ocw 77 0 A.
V/4� _ PLUM
Contact Name & Phone # of JOBSITE SUPERVISOR: 1G qL MALTEF ISELI Uo - 9 & - / 3 7
Subcontractor Info:
ElectricalMechanical ( l�� Plumbing / '�
Framer -71>1) Roofing / 13 b Concrete
Solar
Other
Other
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_ x1zJ w;fj Phone rcr,
70
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater -rWdobea r-vcP&(1 l t,
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
Application Number:
Job Site Address:
New Building
Revised 03/30/2009
i
F. /r
• .
11 q $94 S7L-E c�� /�—
Addition
Building owner: 114A7 r f3o&0
Remodel/TF
Building owner address: / o Z I � ,U1� 57. FT
Building owner phone #: %70 - Vgs -- 7 '�S�
Name of Business: VA)l vl--VS"!y o f 0-O&-45,/L4Aa '.AfjL-7-4 C-e-1,,J/ C-
Proposed Use: (i.e. medical, office, bank, retail, etc)
Project square footage:
V-7?O SF
For commercial remodels Ft tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an (plgase=cf_ le 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 tenant for this unit, what was the previous use of this tenant
Space? A4E61c-4c_ DFFt ce
➢ Are there any exterior building changes associated with the work? Yes or (Fo
If yes, please describe:
W
Sign atu o pplicant
Name (please print)
q 5-1(v
Oate
!270 — 7oz- l '76-<P
Local daytime phone #