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Home My WebLink About3039 CONQUEST ST - PERMITS - 1/4/2021Owner:HAHN MICHAEL/REBECCA 3039 CONQUEST ST FORT COLLINS,CO 80524-7504 Phone:815-262-7062 Zoning:Front setback:Rear setback:Right setback:Left setback: Minor Amend #:Plat File #:ZBA Case #: Zoning district:LMN -LOW DENSITY MIXED-USE NEIGHBORHOOD DISTRICT Legal:Subdivision/PUD:Filing #:Lot #:7 Block #:24 Code:Res sq ft:0 Com sq ft:Ind sq ft:Basement sq ft: #of stories:Occ Group:Const Type: Fire Sprklr:Stock plan #:Stock plan options: Contractor:License #: Phone: Supervisor cert #: Subcontractor(s)Phone License Number Work Description:Basement finish of 575 sq ft to include 1 bedroom,living room,and full bathroom.Homeowner affidavit on file. SCHEDULE INSPECTIONS:**via Text Message:888-406-6394 **By Phone:970-221-6769 **Online Portal:fcgov.com/CitizenAccess **Online Portal via Mobile Device:fcgov.com/CitizenAccess/mobile Possible Inspections Required:201 204 203 302 102 205 200 202 207 303 301 300 TOTAL FEES PAID AS OF 01/04/21:$371.99 Payment method:Credit Card 4420 **Fee Detail Displayed on Next Page As a condition for the issuance of a permit,I hereby declare that I am the owner or owner's agent,authorized to perform the proposed work on the property described herein. I agree to comply with all the requirements contained herein,and City ordinances,and State laws associated with such work.I understand that such permit may be revoked in the event that issuance was based on incorrect information.This permit shall become null and void if the work authorized by such permit is not commenced, suspended,abandoned or not inspected within 180 days from the date of such permit. Carbon Monoxide Alarm required within 15 feet of each bedroom entrance. Community Development &Neighborhood Services 281 N.College Ave Fort Collins,CO 80522 970.221.6760 970.224.6134 -fax Building Permit #:B2013655 Issued Full:01/04/2021 Permit Type:Basement Finish Site Address:3039 CONQUEST ST Job Valuation:$7,506.48 Category:Residential Remodel Signature:Print Name:Date: Form Revised Oct 2010 Transactions Method Check Number Date Paid Amount Paid Comments Credit Card CK #4420 01/04/2021 $371.99 Receipt issued:01/04/2021 Total Paid to Date:$371.99 Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due Building Permit Fee w/Subs 1000.422010 $172.46 $172.46 01/04/2021 $0.00 City Sales/Use Tax 251.122030 $144.50 $144.50 01/04/2021 $0.00 County Sales/Use Tax 100.217030 $30.03 $30.03 01/04/2021 $0.00 Plan Check Flat Fee $25 1000.444010 $25.00 $25.00 01/04/2021 $0.00 TOTAL FEES:$371.99 $371.99 $0.00 TOTAL BALANCE DUE AS OF 01/04/2021:$0.00 Community Development &Neighborhood Services 281 N.College Ave Fort Collins,CO 80522 970.221.6760 970.224.6134 -fax Building Permit #:B2013655 Issued Full:01/04/2021 Permit Type:Basement Finish Site Address:3039 CONQUEST ST Job Valuation:$7,506.48 Category:Residential Remodel Fee Amounts are valid for date of this document only.Fees subject to change without notice. Form Revised Oct 2010 BUILDING PERMIT APPLICATION FOR OFFICE USE APPLICATION NUMBER: APPLICATION DATE: Job Site Address Unit# PROPERTY OWNER INFO: (All owner information is required – NOT optional) Last Name First Name Middle Street Address City State Zip Phone # Email Name of Business (COMMERCIAL USE ONLY) CONTRACTOR INFO: Company Name License Holder Name LIC # CERT # LEGAL INFO: Subdivision/PUD 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 # 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 # of Full Baths ¾ Baths ½ Baths # Fireplaces ENERGY INFORMATION: (CHECK ONE) ComCheck ☐ UA (ResCheck) ☐ SPA (Simulated Performance Alternative) ☐Prescriptive ☐ERI (Energy Rating Index) ☐ Air Conditioning? YES ☐ NO ☐ City of Fort Collins Approved Stock Plan # SP0 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) associated with the work? Yes ☐ No ☐ If yes, please describe: COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416.2740 • www.fcgov.com/building B2013655 12/17/2020 Value of Construction (materials and labor): $ Description of Work: JOBSITE SUPERVISOR CONTACT INFO: Name Phone SUBCONTRACTOR INFO: Electrical Mechanical Plumbing Framing Roofing Fireplace Solar 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). ☐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 Phone # Email THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE Michael L Hahn \815-262-7062 ForTboUins Building Services PO Box 580 ' 281 N College Ave Fort Collins, CO 80524 970-416-2740 phone 970-224-6134 fax HOMEOWNER AFFIDAVIT {AiCh^e.\^ ^ 2^Wf2^2^. I^^U*^ as owner(s) of record of the property located At: 3Q->^ (j>>n^ iy^5>^ , Fort Collins, Colorado, hereby declare and attest I/we to the following: (please check only the one that applies): OPTION 1: OPTION 2: OPTIONS: • I am/ we are acting on my/ our behalf for the purpose of obtaining a building permit and personally constructing my/our home. The home to be constructed is on the above property and will be mv/our primary residence. I/we have not personally constructed any other new homes in the Fort Collins city limits within the past 24-month period. I am/we are acting on my/our behalf for the purpose of obtaining a building permit and personally constructing an alteration or addition to my/our house, acting as our own general contractor. The house to be altered is on the above property and is my/our personal primary residence. • I am/we are acting on my/our behalf for the purpose of obtaining a building permit and personally constructing a non-structural alteration to my/our attached single family dwelling unit. The house to be altered is my/our personal primary residence. I am aware that I/we cannot do any structural, electrical, plumbing or mechanical work and must hire contractors/subcontractors who are currentiy licensed and insured with the City of Fort Collins. I am/we are personally performing all of the work or hiring City of Fort Collins licensed trades people, or will be continuously supervising unpaid volunteers (see Option 3 for attached dwellings). The work is directly related to the construction of the above referenced home. I/we understand that any person(s) or agent(s) contracted to perform structural wood-framing, plumbing, HVAC, electrical or roofing work, MUST BE licensed contractors in accordance with the regulation of the City of Fort Collins. I/we understand that failure to comply with any of the above conditions may result in revocation of any permits associated with the above Permit Application number, forfeiture of any fees that have been collected, a Stop Work Order and potentially a court summons. Sign in the presence of Notary Public Owner The foregoing Affidavit was acknowledged before me on th is IS** t^iajCKtb^ ^020 (month, year) bvM}(^hr.^l CiAcH ^CL.\OC(£(* \~Ultr\ Witness my hand and official seal My commission expires: C^O^J ANN ENOICOTT NOTARY PUBLIC STATE OF COLORADO NOTARY ID 2020401S683 MY COMMISSION EXPIRES 0S4M-2024 Notary Public Revised 6/10/2014 B2013655