HomeMy WebLinkAbout609 WHEDBEE ST - APPLICATIONS - 12/14/2018Cityof
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
FF`6rl Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416.2740 • www.fcgov.com/building
. BUILDING PERMIT APPLICATION
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APPLICATION NUMBER:'
UMB R: < ( yh r". // APPLICATION DATE:
Job Site Address ( 01( )rll�yi u ���'t: Unit#
PROPERTY OWNER INFO: (All owner information is required — NOT optional)
Last Name Cr~^f First Name
Street Address 114e N t:�eJlkje )e� City
Phone # T707g7 %S54 Email
Name of Business (COMMERCIAL USE ONLY)
JG1yPltN Middle
-475d—e: ie1167 State Co Zip
CONTRACTOR INFO: Company Namef/�. %CNDW
License Holder Name , P/N -IQ LIC # CERT #
LEGAL INFO:
Subdivision/PUD Filing # Lot #
CONSTRUCTON INFO: Total Building Sq Ft(NOT including basement)
_
Residential Sq Ft / ommercial Sq Ft # of Stories
1st Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft
Finished Basement Sq Ft
# of Bedrooms
Baths Yz Baths # Fireplaces
ENERGY INFORMATION: (CHECK ONE)
Block # Lot Sq Ft
Total Garage Sq. Ft.
Bldg Ht # of Dwelling Units
Unfinished Basement Sq Ft
# of Full Baths
ComCheck ❑ UA (ResCheck) ❑ SPA (Simulated Performance ❑ Prescriptive❑
Alternative)
Air Conditioning? YES ❑ NO ❑
City of Fort Collins Approved Stock Plan # SPO List Option #s
UTILITIES INFO: Gas ❑ Electric ❑ Electric Temp. Pedestal Yes
Electric Main Breaker Size (Residential Only): 150 amp or less ❑ 200 Amp
ZONING INFO: (COMMERCIAL USE ONLY)
Proposed Use: (i.e. medical, office, bank, retail, etc.)
For Commercial remodels and tenant finishes, please answer the following questions:
Is the remodel/tenant finishes for an existing or new tenant? (Please check one)
16105S57
ERI(Energy Rating Index) ❑
❑ No ❑
❑ Other ❑
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?
If yes, please describe:
Yes ❑ No ❑
Value of Construction (materials and labor):
Description of Work:
a]
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JOBSITE SUPERVISOR CONTACT INFO: Name —t—Md 'Gew f Phone
SUBCONTRACTOR INFO: Electrical
Plumbing Framing
Fireplace Solar
Mechanical
Roofing
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).
I 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 contained herein and City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature 'Fit Type or Print Name'OcTRI>_
Phone# "721• 1,7• -1/23 Email �je,f 'Z .�r,�,e.iJa.l 6/W • GM
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE