HomeMy WebLinkAbout4107 TORRINGTON CT - APPLICATIONS - 8/26/2019F,�o_
Cityo�olhns
rt COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. •Fort Collins, CO 80524 • Phone: 970.416.2740 • www.fceov.com/building
BUILDING PERMIT APPLICATION
FOR OFFICE USE
APPLICATION NUMBER: GIA4K,3(p APPLICATION DATE: Z(p.lq
Job Site Address 410-7 Torrir,9-6v, C4-. 'F+. Call&%-s CO $o5z5 Unit#
PROPERTY OWNER INFO: (All owner information is required—o NOT optional)
r'rex
Last Name '6u.5c,vtsov, First Name I -a LL_ Middle
Street Address L{ 167 T0v-r"nq-1on CA-. City F4 . C-o II: v,s State e.o Zip 8052-5
Phone# q,7o- a_%2--7755 Email c. (qex� h@�wra..Lr•C-0►+-1
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name F—" ke Pec <_ Co v,5l rL-ri-10 r\ LL_C_
License Holder Name R ov% Aru-c.k LIC # 'D- 12-(c CERT #
LEGAL INFO: 39O 'D I
Subdivision/PUD Go tde,,, Vy�LL2s Filing # 3'� Lot # + Block # -7 Lot Sq Ft 10, fo31
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) Total Garage Sq. Ft.
Residential Sq Ft /V( Commercial Sq Ft # of Stories Bldg Ht # of Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft Unfinished Basement Sq Ft
Finished Basement Sq Ft # of Bedrooms # of Full Baths
Baths % Baths # Fireplaces
ENERGY INFORMATION: (CHECK ONE)
ComCheck ❑ UA (ResCheck) ❑ SPA (Simulated Performance ❑ prescriptive❑ ERI(Energy Rating Index) ❑
Alternative)
Air Conditioning? YES ❑ NO ER
City of Fort Collins Approved Stock Plan # SPO List Option #s
UTILITIES INFO: Gas ❑ Electric ❑ Electric Temp. Pedestal Yes ❑ No ❑
Electric Main Breaker Size (Residential Only): 150 amp or less ❑ 200 Amp ❑ Other ❑
ZONING INFO: (COMMERCIAL USE ONLY)
Proposed Use: (i.e. medical, office, bank, retail, etc.)
For Commercial remodels and tenant finishes, alease answer the following questions:
Is the remodel/tenant finishes for an existing or new tenant? (Please check one)
Existing Tenant❑ New Tenant❑
If for a new tenant, is this the first tenant to occupy this space?
Yes ❑ No ❑ If not for the initial tenant for this unit, what was the previous use of this tenant space?
Are there any exterior building changes (including mechanical) associated with the work? Yes ❑ No ❑
If yes, please describe:
-' Value of Construction (materials and labor): $ 33.000.
Description of Work:
JOBSITE SUPERVISOR CONTACT INFO: Name -2oy% Phone 9To -2-2-2-- 62-36
SUBCONTRACTOR INFO: Electrical A II;@ Elm (v; Mechanical
Plumbing
Fireplace
Framing
Solar
Roofing Corvtie�r-sior,erl2coAL�
Other
ASBESTOS STATEMENT DISCLOSURE: In accordance with the State of Colorado Senate Bill 13-152, property owners, applying for a
remodel permit, shall indicate their awareness about their property having been inspected for Asbestos Containing Materials (ACM's).
zI do not know if an asbestos inspection has been conducted on this property.
An asbestos inspection has been conducted on this property on or about (enter date).
An asbestos inspection has not been conducted on this property.
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 conta' ed herein and ' y of Fort Collins ordinances and state laws regulating building construction.
Applicant Signatur Type or Print Name '1Z o n A u- k
Phone# 97o- ZZ2- fv2.3b Email pacdl��yctl<cou.sirucr:oh@ gw,a;l.�ow.
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE