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HomeMy WebLinkAbout1214 NASSAU WAY - PERMITS - 7/13/2021Site Address: 1214 NASSAU WAY Community Development & Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.6760 970.224.6134 -fax Building Permit#: 82105441 Issued Full: 07/13/2021 Perm it Type : Basement Finish Job Valuation: $10,000.00 Category: Residential Remodel Owner: BODE DENNIS A/ELLEN L 1214 NASSAU WAY FORT COLLINS, CO 80525-8873 Phone: 970-217-0122 Zon ing : Front setback ______ Rear setback: _____ Right setback ____ _ Minor Amend#: ______ Plat File#: _____ ZBA Case #: Zoning district: LMN -LOW DENSITY MIXED-USE NEIGHBORHOOD DISTRICT Left setback : Legal: Subdivision/PUD Code: Res sq ft: o Fi ling#: Lot# Block#: ------------------------ # of stories: ---- Com sq ft 0cc Group: Ind sq ft: Const Type Basement sq ft: _5_00 ______ _ Fire Sprklr: Stock plan #: ___ _ ---------------------Stock plan options Contractor: License#: Supervisor cert#: Phone: Subcontractor(s) Phone License Number Work Description : Basement finish of 500 sf to include bedroom , family room, and full bathroom. Homeowner affidavit on fi le . 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 07/13/2 1: $387 .50 Payment method: Credit Card 9890 .. 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 vo id 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 . Signature : Print Name: Date: ------------------------------------- Form Revised Oct 2010 City of k tColli~ Site Address: 1214 NASSAU WAY Community Development & Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.6760 970.224.6134 -fax Building Permit#: B2105441 Issued Full: 07/13/2021 Permit Type: Basement Finish Job Valuation: $10,000.00 Category: Residential Remodel Transactions Method Check Number Date Paid Credit Card CK# 9890 07/13/2021 Receipt issued: 07/13/2021 Total Paid to Date: Fee Descri ~t ion Account Code City Sales/Use Tax 251.122030 County Sales/Use Tax 100.217030 Permit Flat Fee -$155 1000.422010 TOTAL FEES: Amount Paid Comments $387.50 $387.50 Fee Amount Amount Paid Date Paid $192.50 $192.50 07/13/2021 $40.00 $40.00 07/13/2021 $155.00 $155 .00 07/13/2021 $387.50 $387.50 TOTAL BALANCE DUE AS OF 07/13/2021: Amount Due $0.00 $0.00 $0 .00 $0.00 Fee Amounts are valid for date of ~his document only. Fees subject to change without notice. Form Revised Oct 2010 City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES k tColl~ 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416.2740 • www.Jfgov.com/building BUILDING PERMIT APPLICATION FOR OFFICE USE APPLICATION NUMBER: APPLICATION DATE: \ JobSiteAddress t?..ILf /Vt<.~S<tll. Wtl~. Fort ~{fl i,,7 Co Bos-zS-Unit# PROPERTY OWNER INFO: (All owner information is req'uired -NOT optibnal) l as t Name S oJe First Nam e D-eVI V\-i':S Middle /t, ~~~~------~-~----- Street Address j1..t'f fVtt7~a._4 Lua.~ City fov-f-~l{,'r1.s State _C_O_Zip 96S"ZS Phone# q10 ·-2 t7 -o 12. "2. Em ail den bode;t9 g~: (. Name of Business (COMMERCIAL USE ONLY) CONTRACTOR INFO : Company Name license Holder Name UC# CERT# LEGAL INFO : Subdivision/PUD 'Sta.I'\ tov, Cr-eek Filing# 2NJ lot# ~t,_·G __ Blo c k # ~ lot Sq Ft Cf, 000 CONSTRUCTON INFO: Total Buildi ng Sq Ft (NOT including basem ent) "20 ,s-z, Total Garage Sq. Ft . 75""3 Res idential Sq Ft 2b s-e Commercial Sq Ft ___ # of Stories Bldg Ht ___ # of Dwelling Units __ _ 1st Floor Sq Ft 205"""8 2nd Floor Sq Ft ___ 3rd Floor Sq Ft ___ Unfinished Basement Sq Ft C/02 Finished Ba se ment Sq Ft # of Bedrooms # of Full Baths ----- ¾ Baths ½ Baths ENERGY INFORMATION: (CHECK ONE) ComCheck O UA (R esCh eck) 0 # Fi replaces SPA(Si mulated Perform ance O O Prescri ptive Alte rn ative ) Air Conditioning? YES ~ NO 0 ERl(Energy Ratin g Ind ex) 0 City of Fort Collins Approved Stock Plan # SPO list Option #s --------------------- UTILITIES INFO : Gas O Electric □ Electric Temp. Pedestal Yes El ectric Main Bre aker Size (Residential Only): 150 amp or less O 200 Amp ZONING INFO: (COMMERCIAL USE ONLY) Propose d Use: (i.e . m e dical, 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 t e n a nt? (Please ch eck on e) Existing Tenant □ New Tenant □ If for a n e w tenant, is t h is the first tenant to occupy this space? 0 No 0 D Other 0 Yes D No D If not for the initia l t e nant for this unit, wh at w as the previ ous use of t his t enant spa ce ? Are the re any exte rior building c hanges (including m echanical) associated with the work? If yes, please desc ribe: Ye s O No D Value of Construction (materials and labor): ,.__,. $ /D 00 O Description of Work: F1-"'-t~h 0X / "h /J4~W\~ f _ __;__c____....:.___:__~'--lf-''-."'-''-'=-'-::..:__::=_::..._.-+--..::..__--..q:,.-'----'-Le----..L...C-'--=---'--''--='-'-"<..!.>,e:.'.-___ _ 'V\clkd,vr famU\J JOBSITE SUPERVISOR CONTACT INFO: Name D-e YI 11\/S f3ode. SUBCONTRACTOR INFO: Electrical Plumbing Fireplace Framing Solar Phone q70-2tJ ·-ol2 2 Mechanical Roofing Other ASBESTOS STATEMENT DISCLOSURE: In accordance with the State of Colorado Senate Bill 13-152, property owners, applying fo r 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. D A n asbestos inspection ha s been conducted on this property on or about (enter date) D An asbe stos inspection ha s not been co nducted 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 requireme~rtained herein and City of Fort Collins ordinances and state laws regulating building construction. Applicant Signature IJl::::;I--~ a: ~ Type or Print Name .DeYI J1 Is A. &>de Phone# cl?D-z lt -C>' 2-2-Email den boJe I 3 ©f»-<4;'/r ~#f THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE City of k tColli~ Building Services PO Box 580 281 N College Ave Fort Collins, CO 80524 970-416-2740 phone 970-224-6134 fax HOMEOWNER AFFIDAVIT I , __ D'--;e_J'1_YI_T_S __ A_~ __ B_t>_d_e, _______ , as owner of record of the property located at: _/_Z._l-'lf--'I\J_a.~s~s~a~tf'--_LU __ tg+------' Fort Collins, Colorado, hereby declare and attest to the following: (please check only the one that applies): OPTION 1: CONSTRUCTION OF NEW HOME D I am acting on my behalf for the purpose of obtaining a building permit and personally constructing my home. The home to be constructed is on the above property and will be my primary re s idence . I have not personally constructed any other new homes in the Fort Collins city limits within the past 24-month period. OPTION 2: PERMITTED WORK ON DETACHED SINGLE FAMILY HOME )( I am acting on my behalf for the purpose of obtaining a building permit and personally constructing an alteration or addition to my house, acting as my own general contractor. The house to be altered is on the above property and is my personal prjmary residence. OPTION 3: PERMITED WORK ON ATTACHED SINGLE FAMILY DWELLING UNIT. □ I am acting on my behalf for the purpose of obtaining a building permit and personally constructing a non- structural alteration to my attached single family dwelling unit. The house to be altered is my personal prjmary residence. I am aware that I cannot do any structural, electrical, plumbing or mechanical work and must hire contractors/subcontractors who are c urrently licensed and insured with the City of Fort Collins. I am personally perform ing 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 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 und erstand that failure to comply with any of the above conditions may result in revocation of any permits associated with th e above Permit Application number, forfeiture of any fees that have been collected, a Stop Work Order and potentially a court summons. The foregoing Affidavit was acknowledged before me on this_---'\-'3~-\_V_'--___ day of -J l,l\ i 1 201-I (month, year) by_-<,!Ik,_.<..."'-..... cO,_,rlc..:....,:_\ "'-s __.[+---'-'-. _"B_o_ol~k=------ ~~ Witness my hand and official seal My commission expires: 3 / t.1 / ·t.5"' MARY F. HASKEW NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20134010470 MY COMMISSION EXPIRES 03/29/2025 Notary Public Revised 10/19/2020