HomeMy WebLinkAbout424 PINE ST - APPLICATIONS - 10/23/2019City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Flirt Collins
281 N. College Ave. •Fort Collins, CO 80524 •Phone: 970.416.2740 • www.fceov.com/building
BUILDING PERMIT APPLICATION
S I FOR OFFICE USE (�
%PPLICATION NUMBER: F 4-� 1 1 APPLICATION DATE: "I ZiJ
Job Site Address 424 Pine Street, Fort Collins, CO 80524 Unit#
PROPERTY OWNER INFO: (All owner information is required — NOT optional)
Last Name Lance First Name Anne Middle
Street Address 424 Pine Street City Fort Collins State CO Zip 80524
Phone # (970) 493-2628 Email alance@teaching-tree.org
Name of Business (COMMERCIAL USE ONLY) Teaching Tree
CONTRACTOR INFO: Company Name Saunders Heath Construction
License Holder Name Derek Breler LIC # B-462 CERT #
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # — Lot Sq Ft
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) 6,000 SF site Total Garage Sq. Ft.
Residential Sq Ft 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) ElAlternative)
Air Conditioning? YES ❑ NO ❑
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.) Early Education
For Commercial remodels and tenant finishes, alease answer the following auestions:
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: Added fence at property line with new playground landscaping and equipment
in "playground area' .
Value of Construction (materials and labor): $ Paid for with permit B1904138
Description of work: Installation of playground equipment on site at address noted above.
JOBSITE SUPERVISOR CONTACT INFO: Name Craig Mattison
SUBCONTRACTOR INFO: Electrical
Plumbing
Fireplace
Framing
• Solar
Phone (970) 290-4184
Mechanical
Roofing
Other Waterwise Landscaping
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).
❑ I do not know if an asbestos inspection has been conducted on this property.
XI An asbestos inspection has been conducted on this property on or about (enter date) 4/10/17
❑ 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 contained herein and City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature
Phone # 720-666-4929
n�
Amanda Cossack mmm ="°'" """ Type or Print Name Amanda Disney
a.disney@saundersheath.com
Email
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE