HomeMy WebLinkAbout939 SNOWY PLAIN RD - APPLICATIONS - 4/15/2019City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. •Fort Collins, CO 80524 •Phone: 970.416.2740 • www.fceov.com/buildine
BUILDING PERMIT APPLICATION
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1O�iFOR OFFICE USE 1APPLICATION NUMBER: . /// APPLICATION DATE: �� � i♦ �®I1
Job Site Address � 3 °� �n � � � � �� �r� C o (j i v.S Unit#
PROPERTY OWNER INFO: (All owner information is required - NOT optional)
Last Name Ego 46 C_ First Name )< �rJN�77Y Middle C
Street Address 9Zg 5h--wy plat„ /cc/ City F::1�9� Co IV,s State CO Zip go.SzY'
Phone# go f - -71 Z— q �(dEmail KZKn
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name
License Holder Name
LEGAL INFO:
Subdivision/PUD
LIC # CERT #
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (NOT including basement)
Residential Sq Ft Commercial Sq Ft # of Stories
1st Floor Sq Ft
Finished Basement Sq Ft
Total Garage Sq. Ft.
Bldg Ht # of Dwelling Units
2nd Floor Sq Ft 3rd Floor Sq Ft Unfinished Basement Sq Ft
# of Bedrooms J_ # 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 ❑
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. please answer the followine questions:
Is the remodel/tenant finishes for an existing or new tenant? (Please check one)
Existing TenantEl 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:
6-6
Value of Construction (materials and laborh
Description of Work:
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l/ 1 i L't A CYC]_ 1, 1 1 V V L rim, A( L I a-Y r✓ L - • ., v l
JOBSITE SUPERVISOR CONTACT INFO: Name
SUBCONTRACTOR INFO: Electrical
Plumbing Framing
Fireplace Solar
Phone
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 forAsbestos 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 Type or Print Name¢rJ
Phone # 0 1 -7 1 2— / Email K dx' q yA
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE