HomeMy WebLinkAbout4640 VENTURI LN - APPLICATIONS - 3/31/2020City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Flirt Collins
281 N. College Ave. •Fort Collins, CO 80524 • Phone: 970.416.2740 • wwtiv.fcgov.cam/building
BUILDING PERMIT APPLICATION
B2002957 FOR OFFICE USE
APPLICATION NUMBER: APPLICATION DATE: 03-31-2020
Job Site Address ��� �lJ (ien�i, y�r�i Unit#
PROPERTY OWNER INFO: (All owner information is required — NOT optional)
Last Name 2/%g,' First Name 1>6,11al Middle
Street Address �lp Z%lj V&At rr Zahe city s��� �� State Zip 4���
Phone # 20 491-w0gz Email (�I Ali, �7r/ c' �man,_.•�
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Com any Name
License Holder Name aezlu
LIC # li-Yf'1 S CERT #
LEGAL INFO:
Subdivision/PUD if Filing# �Lot# #,o Block# Lot SgFt
CONSTRUCTON INFO: Toq I Building Sq Ft (NOT including basement) (p-j60 Total Garage Sq. Ft.
Residential Sq Ft
1st Floor Sq Ft
Finished Basement Sq Ft
%Baths
Commercial Sq Ft # of Stories
2nd Floor Sq Ft 3rd Floor Sq Ft
# of Bedrooms
Yz Baths
ENERGY INFORMATION' (CHECK ONE)
ComCheck ❑ UA (ResCheck) ❑
# Fireplaces
Bldg Ht # of Dwelling Units
Unfinished Basement Sq Ft
# of Full Baths
SPA (Simulated Performance ❑ Prescriptive[] ERI(Energy Rating Index) ❑
Alternative)
Air Conditioning? YES X 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 following questions:
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) El: !�al) associated with the work? Yes No
If yes, please describe-:- Q? ul lv� i✓ uiS �'V eno r'�co A /6-ern,
Value of Construction materials and labor):
Description of Work -ev ti;11 /k/S
4
JOBSITE SUPERVISOR CONTACT INFO: Name
SUBCONTRACTOR INFO: Electrical A,
Plumbing Gts XlinFraming
Fireplace Solar
P Phone -3
Mechanical 17tiel/ 012il-y'1n�A _
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).
❑ 1 do not know if an asbestos inspection has been conducted on this property.
y An asbestos inspection has been conducted on this property on or about (enter date) a t
❑ An asbestos inspection has not been conducted on this property.
Applicant: I hereby acknowledge that �"ye read this application and state that the above Information is correct and agree to
ments
comply with all requireryw0eifi and City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature /���y�ri
Type or Print Name
Phone # `� �1�� O j�Z/> Email _00 /1 Gym i?
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE