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HomeMy WebLinkAbout4619 S MASON ST - C4 - PERMITS - 4/15/2021 City of Community Development&Neighborhood Services FcDrt 281 N. College Ave FortCollins, CO 80522 970.224.6134 -fax Building Permit#: B2102694 Issued Full: 04/15/2021 Permit Type: Com, Ind or Mixed Use Alteration Site Address: 4619 S MASON ST, C 4 Job Valuation: $0.00 Category: Retail Store<5000 SF Owner: GKT ARBOR PLAZA LLC 211 N STADIUM BLVD STE 201 COLUMBIA, MO 65203-1161 Phone: 970-237-0091 Zoning: Front setback: Rear setback: Right setback: Left setback: Minor Amend#. Plat File#: ZBA Case#: Zoning district: CG -GENERAL COMMERCIAL DISTRICT Legal: Subdivision/PUD• Filing#: Lot#: Block#: Code: Res sq ft: 0 Corn sq ft: Ind sq ft: Basement sq ft: # of stories Occ Group. M Const Type V-B Fire Sprklr: Yes Stock plan#: Stock plan options: Contractor: License#: Supervisor cert#' Phone: Subcontractor(s) Phone License Number Work Description: Permit to claim occupancy for 1200 sf for'Puffs Smoke Shop &Vapes'. No work to be done No change of use. Retail to retail ISCHEDULE 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 , IPossible Inspections Required:, 05 102 402 207 101 202 401 100 303 206 105 104 203 201 200 204 301 300 302 103 400 TOTAL FEES PAID AS OF 04/15/21: $100.00 Payment method: Check 2754 "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. Signature: Print Name: Date: Form Revised Oct 2010 City of Community Development&Neighborhood Services F 'crt llege Ave Fort Collins, CO 80522 Collins 970.221.6760 970.224.6134281 N. Co -fax Building Permit#: B2102694 Issued Full: 04/15/2021 Permit Type: Com, Ind or Mixed Use Alteration Site Address: 4619 S MASON ST, C 4 Job Valuation: $0.00 Category: Retail Store<5000 SF Transactions Method Check Number Date Paid Amount Paid Comments Check CK#2754 04/15/2021 $100.00 Receipt issued: 04/15/2021 Total Paid to Date: $100.00 Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due Building Permit Fee w/Subs 1000.422010 $100.00 $100.00 04/15/2021 $0.00 TOTAL FEES: $100.00 $100.00 $0.00 TOTAL BALANCE DUE AS OF 04/15/2021: $0.00 Fee Amounts are valid for date of this'document only.Fees subject to change without notice. Form Revised Oct 2010 City of Fort COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES 281 N.College Ave. • Fort Collins,CO 80524 • Phone:970.416.2740 • www.fcgov.com/building BUILDING PERMIT APPLICATION FOR OFFICE USE 'APPLICATION NUMBER: APPLICATION DATE: Job Site Address �616'_ ^J ,5 �� g� C- Fr C�tQi�� Unit# PROPERTY OWNER INFO: (All owner information is required-NOT optional) Co - Last Name a , ` NV,Z0R Q1'MFAst Name Middle Street Address \kk., S� T City State ,elip Phone# ?&,4 � „SU9 M Name of Business(COM MERCIAL USE ONLY) " 5 j \I e \AV 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 1 �,p 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 3 Baths 1/2 Baths # Fireplaces ENERGY INFORMATION: (CHECK ONE) ComCheck ❑ UA(ResCheck) ❑ SPAAlternativ Performance ❑ prescriptive❑ ERI(Energy Rating Index) ❑ Alternative) Air Conditioning? YES ❑ NO ❑ City of Fort Collins Approved Stock Plan# SPO List Option#s UTILITIES INFO: Gas ❑ Electric ❑ Electric Temp. Pedestal Yes 0 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 .P No 0 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 . It If yes, please describe: ' Value of Construction (materials and labor): $ Description of Work: y 1ip� L , �c p -I 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) ' 0 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 - —,E�, Type or Print Name '\����\\ / ^��pa©2 �J Phone# 4 /� - ��7 ©©�l Emai US \,1)� lQ . 1 �Q•L • l.l�" 1 THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE 1.(X).:\°k, wNV — — 9io 227 009 l