HomeMy WebLinkAbout4700 Lady Moon Dr - Applications/Addition or Alteration - 03/27/2017City.
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F61 t ` ollm 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov eom/building
` r BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
Job Site Address 4700 Lady Moon Drive, Fort Collins CO., 80528 Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 970.631.6075
Last name Horiike First Name Jim Middle
Street Address 1801 16th St. City Greeley State CO Zlp 80631
CONTRACTOR INFO: Company Name Adolfson and Peterson Construction Contractor Phone # 303.363.7101
Lic Holder Name AP Mountain States LLC DBA Adolfson and Peterson City of Fort Collins License # B-147 Supervisor Cart # 2078-B
Mailing Address 797 Ventura Street City Aurora State CO Zip 80011
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 18,934 gsf addition Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories 1 Bldg Height 18'-4" # Dwelling Units
1" Floor Sq Ft
2nd Floor Sq Ft
Td Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces
Air Conditioning. Yes No Energy info: ( Circle appropriate choice ) 1. ComChec k_ 2. ResCheck w/Air Sealing
3. ResCheck wBlower Door 4. Simulated Performance. Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
List appropriate option
Water Tap Size NA, connect to (e)Sewer Tap Size Already Exists Metered: Yes or No Temp. Pedestal Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp []Other
Value of Construction (including labor, material 8 profit) $ $3,700,000
Description of Work: foundation package for single story medical clinic addition 18,934 gsf
Contact Name 8 Phone # of JOBSITE SUPERVISOR: 812 MW 446-EL N\ Axu vv 720 - 2 S 8 - (7S C7
Subcontractor Info:
Electrical
TBD Mechanical TBD Plumbing TBD
Framer TBD
Solar N/A
Roofing TBD Concrete TBD Fireplace
Other
Other
Other
N/A
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 SignatureL! Print Name I Osioj 44C-CLOA Aw✓ V Phone 720-2-88 - (T S 0
Distribution: White - Office Yellow -Applicant Pink -WWW/Stormwater
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