HomeMy WebLinkAbout323 N WHITCOMB ST - APPLICATIONS - 8/11/2020City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F� wort Collins
281 N. College Ave. •Fort Collins, C080524 •Phone: 970.416.2740 • www.fceov.cam/huildine
BUILDING PERMIT APPLICATION
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APPLICATION NUMBER: ����� / APPLICATION DATE: �j l l�%//
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PROPERTY OWNER INFO: (All owner information is required- NOT optional)
Last Name /3/1/r/_=/2 First Name 131yf?/eMiddle /3.fUUl�-
Street Address 7.eU /c/ %�R Jt)I7 Jf CitY 469 7t eej ll, 5i1 State � U Zip
Phone# "ri76a/;73U(oS— Email Ukk., a,/0 GG1/c7.Z (f
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name 7-13
License Holder Name LIC # CERT #
LEGAL INFO:
Subdivision/PUD Rc-re4/o Filing # Lot # 1C Block # R 73 Lot Sq Ft &C-
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) /.Z / y Total Garage Sq. Ft.
Residential Sq Ft(�0,210 Commercial Sq Ft # of Stories Bldg Ht # of Dwelling Units
1st Floor Sq Ft 43 & 2nd Floor Sq Ft 3rd Floor Sq Ft Unfinished Basement Sq Ft (0,2 (o
Finished Basement Sq Ft # of Bedrooms t # of Full Baths /
Baths / % Baths # Fireplaces
ENERGY INFORMATION: (CHECK ONE)
(Simulated Performance
ComCheck ElUA (ResCheck) ® SPA Alternative) ❑ Prescriptive❑ ERI(Energy Rating Index) ❑
Air Conditioning? YES ® NO ❑
City of Fort Collins Approved Stock Plan # SPO
List Option #s
UTILITIES INFO: Gas ® Electric d Electric Temp. Pedestal Yes ® No ❑
Electric Main Breaker Size (Residential Only): 150 amp or less 1Z 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 El 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,la/borl: $ /S U UOO
Description of Work: e"I VH u rild
e
SUBCONTRACTOR INFO: Electrical Wd2S - (1P Mechanical IV (7- 12 d,' 14're
Plumbing met r `I 6;' Framing J'/3.c9 Roofing 7/3 �
Fireplace 1%1 Solar /(j pq Other 413if- 4° j,4eg e?�
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).
p 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 requirements contained herein and City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature C/-'' \/� `J� Type or Print Name /3All /i R 14K�iL
Phone # r'jl--t[j e?/7 34)4 � Email P- A A _ 16 alcA-F.,? i' , eeApi
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATI DATE