HomeMy WebLinkAbout4380 ZIEGLER RD - APPLICATIONS - 6/8/2012COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins
281 N. College Ave. • Fort Collins, CO 8OS22-OS80 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER f) i Q N:) J APPLICATION DATE Z-
Job Site Address 14-9 8-0 ZcEGL.M kh Unit #
PROPERTY OWNER INFO: (All owner information is required -it is not optional) Phone # 770 - Z a8' ^ j!!21? y Or -
Last nameA2AC.D ` 21 �A.)QLOGIAES First Name Middle
Street Address r'l :3 80 Z[ECLEa �A City J'OA C.�9LL_.,-Aj_S1 State e-0 Zip gpSZ.T
CONTRACTOR INFO: Company Name L+GA l H LOAD S7WOod!/OA] Contractor Phone # q 70 - ZZ / - yz 9 $
Lic Holder Name ko RM 1 / Rje&-L-�q /� City of Fort Collins License # Q - t Supervisor Cent # Zq t -
Mailing Address (�ti AAC-QUE5QC
^'E City A04e l State C0 Zip 80S 2- Ay
LEGAL INFO:
Subdivision/PUD 16r2ES 70n31 - KELLY Z Filing # z Lot # z Block # Lot Sq Ft 70, /0/ Rc4WS
3(00 Z.78
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)., Total Garage Sq Ft
' t PA+e�RpEi
Residential Sq Ft Comm'I Sq Ft # of Stories y Bldg Height4P3 ro # Dwelling Units
1s' Floor Sq Ft
2nd Floor Sq Ft
3r° Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/< Baths '/z Baths # of Fireplaces
Air Conditioning: Yes No Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3:"ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
4 Water Tap Size $ Sewer Tap Size ZI it Metered or No Temp. Pedestal Yes or No
Type of Heat: [L]'Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ Z f g 5�C71 t�0
Description of
E[ Fi eT�r L , Fi caE Syr°�° see.) .4,424 ,Are _Z 4L4gitdj�$ .S'VS?,;L S.
Contact Name & Phone # of JOBSITE SUPERVISOR: GAPR V SwvRoAA 9' 70 - Z 88- DOS `f
Subcontractor Info: �t
Electrical nooA� y L- LEC F- Mechanical 0, 5 E�/A3tZfA4_1 D/, Plumbing A41,ttLLI P'.S Ay/L&.)-,-
Framer Roofing Concrete Fireplace
Solar Other Other Other
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 Ci
ty on Collins ordi g es and state s regulating buildingconstruction.
Applicant Signature � /� 0 Print Name SZEJE O,�C_C1j4/t7 Phone970 - `/W-9oy9
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
FCity of Planning, Development and Transportation
OIeee` Collins PO Box 580
/ � 281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134fax
Commercial Construction Application Information
Revised 03/30/2009
Application Number: 12-0 az;>�
Job Site Address: if go ZIFOtrO a Fo,77i C&-LIA) ' Co 5?o5-T5-
New Building
Addition
Building owner: AuA&o 147S
Remodel/TF
Building owner address: tf 3 &o zJ�'GLa Ph Fae—d coe -&js co SDS"ZS
Building owner phone #: 97o - Za& - 0 3 Y q
Name of Business: Ava440 iEWAuc9Loc1,cS
Proposed Use: (i.e. medical, office, bank, retail, etc)C[EAA) A_M F. 8 SeM X—S49c€S
Project square footage:
For commercial remodels-& tenant finishes, please -answer the -.following questions:
➢ Is the remode t inishes for an (please circle answer)
existing tenan - or new tenant?
--------------
➢ If for a new tenant, is this the first tenant to occupy this space? Yes or No
➢ If not the initial tenant for this unit, what was the previous use of this tenant
Space?
➢ Are there any exterior building changes associated with the work?
If yes, please describe:
Signature of applicant
Name (please print)
Yes or °®
!P - Fs -
Date
970 - Y90 - Fro -V `l
Local daytime phone #