HomeMy WebLinkAbout2212 THREE OAKS CT - PERMITS - 3/26/2021Owner:JUSZAK LORI
2212 THREE OAKS CT
FORT COLLINS,CO 80526-6445 Phone:970-214-6667
Zoning:Front setback:Rear setback:Right setback:Left setback:
Minor Amend #:Plat File #:ZBA Case #:
Zoning district:RL -LOW DENSITY RESIDENTIAL DISTRICT
Legal:Subdivision/PUD:Filing #:Lot #:Block #:
Code:Res sq ft:0 Com sq ft:Ind sq ft:Basement sq ft:260
#of stories:Occ Group:Const Type:
Fire Sprklr:Stock plan #:Stock plan options:
Contractor:BLUELINE ELECTRIC LLC
3757 DALTON DR
FORT COLLINS,CO 80526
License #:ME-1187
Phone:970-568-8239
Supervisor cert #:
Subcontractor(s)Phone License Number
Electrical:BLUELINE ELECTRIC LLC 970-568-8239 ME-1187
Work Description:After the fact basement finish of 260 sq ft to include 2 bedrooms.Work done by previous homeowner prior to
2020.Remainder of basement to remain unfinished at this time.Homeowner affidavit on file.Current work to include electrician
updating to GFCI/AFCI outlets.Job contact:Lori Juszak 970-214-6667
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 03/26/21:$165.46 Payment method:Credit Card 7407
**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 #:B2102228
Issued Full:03/26/2021
Permit Type:Basement Finish
Site Address:2212 THREE OAKS CT
Job Valuation:$450.00 Category:Residential Remodel
Signature:Print Name:Date:
Form Revised Oct 2010
Transactions
Method Check Number Date Paid Amount Paid Comments
Credit Card CK #7407 03/26/2021 $165.46
Receipt issued:03/26/2021 Total Paid to Date:$165.46
Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due
City Sales/Use Tax 251.122030 $8.66 $8.66 03/26/2021 $0.00
County Sales/Use Tax 100.217030 $1.80 $1.80 03/26/2021 $0.00
Permit Flat Fee -$155 1000.422010 $155.00 $155.00 03/26/2021 $0.00
TOTAL FEES:$165.46 $165.46 $0.00
TOTAL BALANCE DUE AS OF 03/26/2021:$0.00
Community Development &Neighborhood Services
281 N.College Ave Fort Collins,CO 80522
970.221.6760 970.224.6134 -fax
Building Permit #:B2102228
Issued Full:03/26/2021
Permit Type:Basement Finish
Site Address:2212 THREE OAKS CT
Job Valuation:$450.00 Category:Residential Remodel
Fee Amounts are valid for date of this document only.Fees subject to change without notice.
Form Revised Oct 2010
A�-+4>--�ct· \1�s� 0..e.Jro6-s. �vrt�+., r j v'S-'r y:?v.r�i;-er.(' � � �S.Q_ w-er� �\�� hie/'e�
City of ,ktColli� 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
PPLICATION NUMBER: APPLICATION DATE:
Job Site Address � ;t / <?( =::lb ('" ee C)a.,K.S Co 1..1-r--r
PROPERTY OWNER INFO: (All owner information is required -NOT optional)
Last Name J u s -z... o...,V1...... First Name L o ....,,-;Middle ----------
Unit#
Street Address ';;;l..?. l ::i. ':::rkit'ez Oo...V-s Cf City �0/-r-C\ \,""0 State C...O Zip ?fo.£2.(o
Phone# 970-;?.1'-+-lo{p(p r Email \ or, @J 12 s::z.a)·< �\h.t , u,Yv-V1
Name of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name -------------------------
License Holder Name
LEGAL INFO:
-------------------UC# CERT#
Subdivision/PUD Si\ V'ef D a ... V'-S Filing# 3_.,,,d Lot# 4 9 Block# __ Lot Sq Ft (£J, 7 S-:
CONSTRUCTON INFO: Total Building Sq Ft (NOT including basement) ;J.. 3 D7 Total Garage Sq. Ft. l/-'if'-/
Residential Sq Ft � 00·7 Commercial Sq Ft # of Stories __ Bldg Ht # of Dwelling Units __ _
1st Floor Sq Ft ! t <g '-f 2nd Floor Sq Ft Lf )D 3rd Floor Sq Ft Unfinished Basement Sq Ft 3 7 O
Finished Basement Sq Ft 9-. {_() 0 #of Bedrooms 3 # of Full Baths
% Baths \ Yz Baths
ENERGY INFORMATION: (CHECK ONE)
ComCheck D UA (ResCheck) D
#Fireplaces
SPA(Simulated Performance D PrescriptiveO Alternative)
Air Conditioning? YES g:j NO 0
City of Fort Collins Approved Stock Plan # SPO List Option #s
ERl(Energy Rating Index) 0
-------------------
UTILITIES INFO: Gas Bf Electric � Electric Temp. Pedestal Yes
Electric Main Breaker Size (Residenti al Only): 150 amp or less O 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 TenantD New TenantO
If for a new tenant, is this the first tenant to occupy this space?
0
D
No
Other
Yes D No O 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 D No D
------------------------------
B2102228 3/26/2021
$ L/C-.Q�Value of Construction (materials and labor): +:.,; <
Description of Work: £ .e.. c... +vfC. )' 0-:!'.'\ ,Yt rk ,1 ld G f;cr / /}� CL,s � we M s+,d t�
<; o ( £ C \ o 5 � & oL h..dl&..JG..ct � @;G S' \4: -r:::f'
JOBSITE SUPERVISOR CONTACT INFO: Name
SUBCONTRACTOR INFO: Electrical fsl vE' L ;::1e-£ \ ,e__ ct( �c..Plumbing
Fireplace
Framing
Solar
Phone
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).
� 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 contain ein and City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature Type or Print Name Lor,-J us�
Phone# Email 0 '< { @> J V S:::z.o..k �a...,\ :t:'-1 1 cQYV'1
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City of �tColli� Building ServicesPO Box 580 281 N College Ave Fort Collins, CO 80524
970-416-2740 phone 970-224-6134 fax
HOMEOWNER AFFIDAVIT
I , ___ L __ o_.r-_(_J_v�.s-� __ k_'---________ , as owner of record of the property located at:
8' '.l l � �� Oo. Ks G u/.1: , 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 myprimary residence. 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 D 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. Thehouse to be altered is on the above property and is my personal primary residence.
OPTION 3: PERMITED WORK ON ATTACHED SINGLE FAMILY DWELLING UNIT. i§' I am acting on my behalf for the purpose of obtaining a building permit and personally constructing a nonstructural alteration to my attached single family dwelling unit. The house to be altered is my personal primary residence. I am aware that I 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 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 theabove referenced home.
I understand that any person(s) or agent(s) contracted to perform structural wood-framing, plumbing, HVAC, electricalor roofing work, MUST BE licensed contractors in accordance with the regulation of the City of Fort Collins.
I 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.
The foregoing Affidavit was acknowledged before me on this cl S-+""'-day of
tJ\cv..c.. h, J, O d.. \ (month, year) by ____ L_o_c _; __,.__u_S_'2.A._V'.-_____ ___,........,_......,._
Witness my hand and official seal My commission expires: 1.pJ2ci, /.;,.o2�
ROBERT SCHULZ NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20204022832 IKf COIIMIS810N EXPIRES 08i2M02' Revised 10/19/2020
B2102228
City of �Colli�
PERMIT AND INSPECTION REQUEST FOR
EXISTING NON-STRUCTURAL CONSTRUCTION
Please print or type
Address: c2 :J.. I?-"---rhv---e--e. 00-Ux Co,,/+
Date: _______ 0 ___ /_�_0_/._�_..,__o _·--._-_,_I _______________ _
I/WE ___ l---_0_..,_:_J_v_s_·-:z_'-""'_<_z ____________ ., as owner(s) of
record of the above property, hereby request a permit for and final inspection of the
installation or construction work described in the following building permit
application, which work was completed or covered without obtaining a permit and
without reqvired inspections during construction. I/we understand and agree that
the City of Fort Collins B_uilding & Zoning Department will perform a final inspection to
assess compliance of such work, some or all of which may be concealed by
permanent construction and finish materials, based on observable conditions and
nondestructive methods: and, that it may not be practical or possible for the City of
Fort Collins to verify full compliance with City building codes without removal of such
permanent construction and finish materials. I/we further understand that any
violations of City Codes related to health and safety associated with the above work
or installation may require correction.
Work performed by:
,S V 0 lo-J -C \ E C +--v-{ C..... U< :r·i1_ J_ -,,.:r h
J3 I u-e. L J'vi -e I:!.,} e c �v, c :J IS--/ brA.,{ }r,v1 D /
Nome Address Y::--o/-i-<:O ( \ ,. -s � o 5" 2 (p
Date work performed: __ 2-+-/_;;... ....... ,-----+-/-� __ o_�_-· "'-J --------------
(Signature) � Date ________ _
(Signature} _______________ Date _______ _ --------------------------------------------------------------------.................... , ................................................ .
For office use only:
Permit/Application Number ____________________ _
Date applied: _________________ ,;_..._ ___ _
B2102228
3/26/2021
City of ktColli�
Planning, Development & Transportation Services
Community Development & Neighborhood Services
281 North College Avenue
P.O. Box580
Fort Collins, CO 80522.0580
970.416.2740
970.224.6134-fax
fcgov.com
After the Fact Basement Finish Requirements
Address � J, I � -rn V"'e e._ 0 o___ (,{ .s G v0+-Permit No. B ·2, I O � ·;)_ :1.. i
With the issuance of this "After the Fact" permit, the City makes no statement about, assumes no
responsibility for, nor inspects any construction component behind the drywall. The following
items are required and will be verified by the City building inspector.
•Electrical outlet spacing, outlets shall be installed within 6 feet of doorway edges and
within 12 feet of each other outlet as measured along the floor perimeter.
•Tamper resistant outlets, all new outlets within the scope of work identified on the
permit, shall be tamper resistant.
•Arc fault protected, all new outlets within the scope of work identified on the permit,
shall be protected by an Arc Fault outlet or breaker.
•Ground fault circuit interrupter, all new outlets installed in bathrooms or serving
counter space with wet sinks shall be GFCI protected.
•Smoke alarms, are required within each bedroom and outside the sleeping area,
throughout the home, may be electrically connected or battery operated.
•Carbon monoxide alarms, homes with attached garages or gas fired equipment; one
alarm is required within 15 feet of sleeping areas, throughout the home.
•Exhaust fan, bathrooms without an openable window shall be provided with an exhaust
fan ducted to the outside.
•Guardrails and handrails, stairs shall be provided with guardrails where needed and all
stairs of 4 or more risers shall be provided with one handrail extending the entire length
of the stairway.
•Stairway landings, all stairs shall have a clear 36 inch by 36 inch landing at the bottom
of the stair.
•Stairway protection, stairways shall be enclosed or shall be protected on the back
(underside) of the stringers with minimum of lh inch sheetrock.
•Closet lighting, light fixtures installed in closets shall be a minimum of 12 inches from
shelf edges.
•Egress windows, basements shall have at least one egress window which provides 5
square feet of clear openable area or door leading directly to the outside, additionally all
bedrooms shall have an egress window or door leading directly to the outside.
After the Fact Basement Finish Requirements.
•Egress window wells, new egress windows shall be provided with window well ladders.
•Mechanical equipment, mechanical closets containing fuel burning appliances shall not
be accessed through a bedroom or bathroom.
•Mechanical equipment access, mechanical rooms and closets shall have access doors
large enough to remove the largest piece of equipment. Removal of one piece of
equipment shall not require the removal of another piece of equipment.
•Mechanical air path, forced air mechanical systems shall be provided with a return air
path back to the equipment. The return air path shall be by ductwork or transfer grills and
openings with limited obstructions.
•Gas burning fireplaces shall be directly vented to the outside.
•Gas piping, all new gas piping shall be under a 10 pound air test during the City
inspection.
•Wood burning appliance, all wood burning appliances shall require a separate permit
and inspection.
•Plumbing, all plumbing fixtures shall be constructed of approved materials, with smooth,
impervious surfaces.
•All plumbing fixtures shall be provided with potable water, hot and cold as required by
the fixture.
•Gray water systems are required to be approved prior to installation and require a
separate permit and inspection.
Owner's Name Print Owner's signature
-2-