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Home My WebLink About3138 TWIN WASH SQ - PERMITS - 3/19/2021Owner:GORELY ALEKSANDER/AMANDA 3138 TWIN WASH SQ FORT COLLINS,CO 80528-9437 Phone:970-396-3064 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 #:Block #: Code:Res sq ft:0 Com sq ft:Ind sq ft:Basement sq ft:1160 #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 1160 sq ft to include rec room,1 bedroom,3/4 bathroom,and unfinished storage space. Homeowner affidavit on file.Job contact:Aleksander Gorely 970-396-3064 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 03/19/21:$972.19 Payment method:Credit Card 7318 **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 #:B2100098 Issued Full:03/19/2021 Permit Type:Basement Finish Site Address:3138 TWIN WASH SQ Job Valuation:$35,148.00 Category:Residential Remodel Signature:Print Name:Date: Form Revised Oct 2010 Transactions Method Check Number Date Paid Amount Paid Comments Credit Card CK #7318 03/19/2021 $972.19 Receipt issued:03/19/2021 Total Paid to Date:$972.19 Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due City Sales/Use Tax 251.122030 $676.60 $676.60 03/19/2021 $0.00 County Sales/Use Tax 100.217030 $140.59 $140.59 03/19/2021 $0.00 Permit Flat Fee -$155 1000.422010 $155.00 $155.00 03/19/2021 $0.00 TOTAL FEES:$972.19 $972.19 $0.00 TOTAL BALANCE DUE AS OF 03/19/2021:$0.00 Community Development &Neighborhood Services 281 N.College Ave Fort Collins,CO 80522 970.221.6760 970.224.6134 -fax Building Permit #:B2100098 Issued Full:03/19/2021 Permit Type:Basement Finish Site Address:3138 TWIN WASH SQ Job Valuation:$35,148.00 Category:Residential Remodel Fee Amounts are valid for date of this document only.Fees subject to change without notice. Form Revised Oct 2010 :OZ/£1/9 r Citytocf ll �or o ins '�- COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416.2740 • BUILDING PERMIT APPLICATION FOR OFFICE USE PPLIC AT ION NUMBER: APPLICATION DATE: JobSiteAddre ss 3138 ivJ1Y'\ W Cl$b sg Fo(t Collins I Co cOS18PROPERTY OWNER INFO: (All owner information is required -NOT optional) Unit# Last Name �G�o��-=-e\-y ______ First Name A I eks Cilnd.e.C Middle G----''-'------- Street Address 3 \) & Tw,n Wo. �� Sc<. City Po c+ C"II; V\S Phone# �70-396 -30{, 4 'Email �\e �. <j or-e.\ycJ '3h'lQi\_ Com State CO Zip 80Sl.8 Name of Business (COMMERCIAL USE ONLY) CONTRACTOR INFO: Company Name -------------------------- License Holder Name UC# LEGAL INFO: CERT# -------- Subdivisi on/PUD J:a<;.s1J Lci ke, PUD .Filing# / sr Lot# -'-1_5 __ Block # 3 Lot Sq Ft 9, 9 SJ.- CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) 3, Qd-..t_J Total Garage Sq. Ft. j ----- Residential Sq Ft Commercial Sq Ft # of Stories 2 Bldg Ht # of Dwelling Units __ / __ 1st Floor Sq Ft / � 30 2nd Floor Sq Ft / '3')9 3rd Floor Sq Ft Unfinished Basement Sq Ft { 6 8 3 Finished Basement Sq Ft # of Bedrooms 5 # of Full Baths 1----------% Baths Yz Baths ENERGY INFORMATION: (CHECK ONE) ComCheck D UA (ResCheck) 0 Air Conditioning? YES @ # Fireplaces SPA(Simulated Performance D Pre scriptiveOAlternative) NO D ERl(Energy Rating Index) D City of Fort Collins Approved Stock Plan# SPO List Option #s ---------------------- UTILITIES INFO: Gas liJ Electric IQ] Electric Temp. Pedestal Yes Electric Main Breaker Size {Resid ential Only): 150 amp or less D 200 Amp 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 TenantO NewTenantD If for a new tenant, is this the first tenant to occupy this space? 0 No 0 uZi Other D Yes D No D 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 VP� n(p;:i�p fip�rrihp• JO 1 ��d Yes D No B2100098 1/6/2021 :oz/£ *'ue of Construction (materials and labor):$ / <J J OOQ 1111 ·id p-JS'BA DescriptionofWork: Fro.)")� baseMeY):r accocd1na ±v plc.)')s \bsmJ/ ele.ctr,CCA1 a;f\of p\(1W\"'1n3 Dece4St1lfj . l1'$h-t}) drvv1all I ;r;l�ocs I +t{M I. a� pqiht IA)qll,s (,(1/\d JOBSITE SUPERVISOR CONTACTINFO: Name Afek?O-'nJ..er Gor€-)'j SUBCONTRACTOR INFO: Electrical Plumbing Framing Fireplace Solar Mechanical 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). utl I do not know if an asbestos inspection has been conducted on this property. D An asbestos inspection has been conducted on this property on or about (enter date) D 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 � Phone# �(O-��:b-306.lf City of �s Building ServicesPO Box 580 281 N College Ave Fort Collins, CO 80524970-416-2740 phone 970-224-6134 fax HOMEOWNER AFFIDAVIT Vwe, A\ds?4)'\Jer U .9f'eJ L1, At: 3]) O :[w'1Vi lNet:SVl S1 , as owner(s) of record of the property located , Fort Collins, Colorado, hereby declare and attest to the following: (please check only the one that applies): OPTIQNt; a QPTIQN2; ffi OPTIQN3: a I am/ we are acting on my/ our behalf for the purpose of obtaining a building permit andpersonalty constructing my/our home. The home to be constructed is on the above property andwill be my/our primary residence. I/we have not personally constructed any other new homdS 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 andpersonally constructing an alteration or addition to my/our house, acting as our own generalcontractor. The house to be altered is on the above property and is my/our personal primaryresidence. I am/we are acting on my/our behalf for the purpose of obtaining a building permit andpersonally constructing a non-structural alteration to my/our attached single family dwellingunit. 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 currently 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 becontinuously supervising unpaid volunteers (see Option 3 for attached dwellings). The work is directly related to the construction of the above referenced home, which is described more fully on Permit Application # ---------(obtained from the Building Services office). 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 Cityof Fort Collins. I/we understand that failure to comply with any of the above conditions may result in revocation of any permitsassociated 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 �(H;= Owner Q>..owner The foregoing Affidavit was acknowledged before me on this S ·, X th day of J Cd) l,W( � ; 'J. 0 J O (month, year) by J\..' e., '6sDN/:H Got e, l y Witness my hand and official sealMy commission expires: 1 /J� / lj JOSHUA HEARNE NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20194036323 MY COMMISSION EXPIRES Sl:PTEMBER 24, 2023 B2100098