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HomeMy WebLinkAbout613 FOXTAIL ST - APPLICATIONS - 5/8/2019City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES F� F6rt Collins 281 N. College Ave. •Fort Collins, CO 80524 •Phone: 970.416.2740 • www.fceov.com/building BUILDING PERMIT APPLICATION (� � FOR OFFICE USE PPLICATION NUMBER:� 1 6 2 J0 1, 1 APPLICATION DATE: s Job Site Address tp 13 �_©X- at 1 51"1 Unit# PROPERTY OWNER INFO: (All owner information is required1— NOT optional)` Last Name (34 First Name 5 L2�h�vt °( -ijq Middle L Street Address (e t3 �px �1 >A City :FOi/kCoState 6Zip Phone # rj' Zy —Z (IZ Email Name of Business (COMMERCIAL USE ONLY) /w 1H CONTRACTOR INFO: Company Name 'D r-u-c. V_ G yi4-e v-T) rt S-e S License Holder Name LEGAL INFO: CERT# 1�nok D' Subdivision/PUD L Ve!:jj> etPt �coelc— Filing # 2 Nd Lot # rj/ Block # 41 Lot Sq Ft CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) Total Garage Sq. Ft. Residential Sq Ftq6 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 % Baths Y2 Baths # Fireplaces ENGERGY INFORMATION: (CHECK ONE) # of Full Baths ComCheck ❑ UA (ResCheck) ❑ SPA(Simulated Performance ❑ prescriptive❑ Alternative) Air Conditioning? YES ❑ NO ❑ ERI(Energy Rating Index) ❑ 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 following ouestions: 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): S ZZ� Ow,00 -4 t-in i cm�-Jd C0 1� 6 S P -4 S k `"A-e bec "{mil r(i-&-VL l JOBSITE SUPERVISOR CONTACT INFO: Name SUBCONTRACTOR INFO: Electrical �pC-� krzfh (�'(Pa� ri C, Z��-7a- Plumbing Ier'S�rw S k`� Framing Fireplace Solar Phone q70 Z600 `Z5z7 chanical 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). [ 1 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 re trements�ontai te" �a�n�d City of Fort Collins ordinances and state laws regullating building construction. Applicant Signature L' i 7\"-- Type or Print Name �av 77 r-k C �C— Phone# 0-tCQC) Z Email �ctv�tP�J t:>PM�Pr1�ri5�5� C THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE