HomeMy WebLinkAbout4380 ZIEGLER RD - APPLICATIONS - 7/8/2013City of II COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
)1,2013
APPLICATION NUMBER ) 'J!/ �'l�o— APPLICATION DATE C/
Job Site Address��2p TIEGLc , kb Unit #,
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 9 %O "299^ 02 qie
Last nameh!m(o j CC I{�r��LIFS First Name
Middle
Street Address y'3 30 `L(F(;j_" 96 City &JZ I State Co Zip &057
CONTRACTOR INFO: Company Name k FA i COAZS(POil QA) Contractor Phone # 777 2-2( y( 9�
Lic Holder Name Qo R F-A'r 41:74V City of Fort Collins License # A . 1 Supervisor Cert # '29 f
Mailing Address W 1 kACw Ft' t_ City-h,3,� t 62OLL-1,0S State C=c) Zip 80,< 2 q
LEGAL INFO: //��
Subdivision/PUD1-'>QE S 1 OA) r"i �i 2 Filing # Lot # Z Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
-rRAJK '1
Residential Sq Ft Comm'I Sq Ft # of Stories .8idg Height_ # Dwelling Units
151 Floor Sq Ft
Finished Bsmt Sq Ft
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
3'd Floor Sq Ft
# of Bedrooms # of Full Baths 3/4 Baths
Unfiished Bsmt Sq Ft _
'/2 Baths # of Fireplaces
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
List appropriate option #s
Water Tap Size Sewer Tap Size 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 & profit) $ 2 G>
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR: GAAY S ww R o4 A q %D -y 2n - Z/ 2-00
Subcontractor Info:
Electrical
Framer Roofing
Solar Other
Mechanical (A a , Plumbing
Concrete
Other
Fireplace
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 City of rt Collins ornces and stat laws regulating building construction.
Applicant Signature �y, 44., � 2� Print Name S (EJF_- k GSdCef" /l7 PhoneQ%
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
City of Planning, Development and Transportation
Fort 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 Numbep
0
Job Site Address: %38o Z1-Ec_crEcO /A z"7cow.,7S cd E-DSz�
New Building
Addition Remodel/TF
Building owner: AM60 ; c1>raa L-016f S
Building owner address: z /FaAD Fi C-az 7S,, cn &0sZS
Building owner phone M 970 , ; R a , 03 �z 4c
Name of Business: A Wa-0
Proposed Use: (i.e. medical, office, bank, retail, etc)
Project square footage: fib YW
For commercial remodels & tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an (please circle answer)
sting enan 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:
d-,Z - n
Signature of applicant
Name (please print)
7 g— / Y
Date
Yes or
Za? -J5�7-L/`?
Local daytime phone #