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Home My WebLink About430 N COLLEGE AVE - APPLICATIONS - 5/30/2019City of �rtCollins COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES 281 N. College Ave. *'Fort Collins, CO 80524 • Phone: 970.416.2740 • www.fcgov.com/building BUILDING `PERMIT APPLICATION I .• FOR OFFICE USE 4PPLICATION NUMBER: �� L APPLICATION DATE:�� Job Site Address PROPERTY OWNER INFO: (All owner information is required — NOT optional) Last Name First Name �•S f1,G�► Street Address %13i'l t.k. W taa.�li�,�t �1 V.4 LT lzm Phone# ilo-%11I• 66-IS Email i0kr1.SkQ'�Iv-IL C.ot Name of Business (COMMERCIAL Use ONLY) 0�96_@ �kb..&a_ I ;.w Middle CONTRACTOR INFO: Company Name "lio bitr C.OK-x1rL ZT101q IKC. License Holder Name '%SeAN tma�.g LIC # LEGAL INFO: Subdivision/PUD Unit# State Zip _MZL0 CERT # Filing # Lot # Block # Lot Sq Ft CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) Total Garage Sq. Ft. �• Residential Sq Ft Commercial Sq Ft -S_# of Stories _�LBldg Ht(D-j # of Dwelling Units -Q• 1st Floor Sq Ft Zg 2nd Floor'Sq Ft ',p 3rd Floor Sq Ft 3i�unfinished Basement Sq Ft 4b Finished Basement Sq Ft -49- # of Bedrooms -9' -# of Full Baths .p Baths -Q % Baths .} # Fireplaces -� ENERGY INFORMATION: (CHECK ONE) ComCheck ❑ UA (ResCheck) ❑ SPAAlternative Performance W � InN ❑ prescriptive❑ ERI(Energy Rating Index) ❑ Alternative Air Conditioning? YES 'X NO ❑ City of Fort Collins Approved Stock Plan # SPO List Option #s —12r UTILITIES INFO: Gas Electric X 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 auestions: Is the remodel/tenant finishes for an existing or new tenant? (Please check one) Existing TenantX 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): $ y,5 "rdab e,� Description of Work: Cbo�7S"rQ.�C.Ttbb.f c�F If�tQ#0 16RcAiL,dw(as QaLV,,t) t� ��OS1aL I&ILF-A Oi FttF— JOBSITE SUPERVISOR CONTACT INFO: Name Phone . SUBCONTRACTOR INFO: Electrical CgaSEYSL.r��,'>?Roe� Mechanical 1 Plumbing 141A Framing .1;>9AS)- Z Q�o. Roofing 81A Fireplace pe( (4 Solar N I A _ 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 awdreness dbout their"property having been inspected forAsbestos Con taini ig'Materials (RCM's) I do not know if an as&stos inspection'hi s been cond'uctedon 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 xzz�_ Type or Print Name JEA V4 kV US Phone# `S\g1.� 0"y Email 5pmQ rt, P,C-ptt51.COY� THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE G� Planning, Development & Transportation Services City of Community Development & Neighborhood Services 81 North College Avenue Flirt Collins r�(��'Q - Fort Collins, CO 80524 970.416.2740 Commercial Tenant Finish and Remodel Checklist for Submittal Requirements Adopted Codes: 2012 IBC, IMC, IFGC, IECC, 2015 IPC, 2014 NEC, [CC-A117.12009 (Revised 1/27/17) (n�t�a►; Required;af time of,permit submittal , . Building Permit Application Commercial Construction Application Plan Check Fee Stamped Structural, Mechanical, Electrical, Plumbing and Architectural Drawings are required for any of the following: �* Structural Modifications �I 4 r4 Scope of work greater than 5,000 square feet First Tenant to occupy a space Change of Occupancy (see additional handout) New 3 phase service or service change of 225 amps or greater -Stamp for Electrical Scope Only. Existing and Proposed Scaled Drawings (2 copies) Floor Plans with room labels and areas Reflected Ceiling plan with lighting MIA Interior Elevations including restrooms c U 14V Structural Drawings (by a licensed State of Colorado Structural Engineer) -must meet local design criteria and adopted building code. Exterior Elevations (see Zoning requirements) 14kNwall types, sections and details. Mechanical Drawings (2 copies) I4A 1 (4` Drawings to show supply, Return, Exhaust, Hoods, and other special equipment. A Electrical Drawings (2 copies) E�1 �1 Outlets, panel location, special equipment. p.(�Plumbing A Drawings Waste and Vent Isometric, Supply, Special Equipment. Lighting Wattage Worksheet or ComCheck Required for Lighting alterations more than 50%. Initial Require-d prior to pe_rmit'issuance. (permits.cannot.,, picked up without the,followir g) • Asbestos Awareness Form Owner Authorization Construction Waste Management Plan Form (Required for a scope of work over 2,500 sf.) NlW1 Initial Other Departments`requiremer t's- ` Larimer County Health Department (�4 970-498-6785 www.larimer.org/health/ehs/food.asp Required for food or drink service, preperation, or processing, daycares, schools and healthcare. Energy Assessment 970-416-2032 4 Free assessment by Fort Collins Utilities. Required for alteration valuations of $50,000 or more, that have not had an assessment in the past 3 years Poudre Fire Authority 970-416-2891 www.Poudre-fire.org/servicesZpermits.php Separate Submittal / Fire suppression modifications may be required. Zoning 970-416-2745 zoning@fcgov.com y'I Change of Use or Exterior modifications (i.e.: fagade, parking, landscaping, or other changes visible to the public), may require a minor amendment. Contact Zoning for more information. Please be aware that only complete submittals can be reviewed. Incomplete or deferred submittals will not be accepted. Applicant Name: fq to htg l Job Site Address: �C � Phone: Email (Required):