HomeMy WebLinkAbout4380 ZIEGLER RD - APPLICATIONS - 1/12/2010PROPERTY OWNER INFO: (All owner information is required - it is not optional)
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BUILDING PERMITS RL INSPECTIONS DIVISION
P.O. Box 580 •Fort Collins, CO 80522-0580 • Phone: 221-6760
,a www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE l~ I�,- ao(,0
Job Site Address 4-MD%IEC-C GE , �D Unit #@@
Phone # 2-38 03L�tt
Middle
i
Street Address L'660 ig� ?'n City State CO zip ;-2:;
CONTRACTOR INFO: Company Name �EA COiiS17Z1IGTlOh( Contractor Phone # Ltl�o tc" Q
Lic. Holder Name?, &TN City of Fort Collins License #jk- I Supervisor Cert #
Mailing Address {?0 V"W-�2_ Cit60L.1_1 rkS State CO zip 805-221
LEGAL INFO:
Subdivision/PUD "WGSTOPI keLj-r--y Filing # Z Lot # Z
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) /Ga/ C0Q
Block # Lot gq-R � & / A.
Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft 00 # of Stories 2. Bldg Height # Dwelling Units
1st Floor Sq Ft2nd Floor Sq Ft C,0jCX10 Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/4 Baths /3 Baths # of Fireplaces
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
UTILITIES INFO:
Water Tap Size � Sewer Tap Size
List appropriate option
Metered: Yes or No Temp. Pedestal: Yes or to )
Type of Heat: R'Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ OCIO Description of Work: 1 04. .ta Ff I'I f S JA ':ol' %I W Q(/AO tF l.(N52, N , 5
-TO .c�cccm e rwir- TeN4oNToRA�7af�1
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical yf /lyE= Mechanical Plumbing
Framer 7p=(nC..C. 4 % UA:-U2oofing Concrete Other
Applicant: I hereby ackno a that I have ad this application and state that the above information is correct and agree to comply with all requirements
contained herein and y of Fort Collins mances and state laws regulating building construction.
Applicant Signature Print Name �rti�GjAq Phone
uti . White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE
City Of Planning, Development and Transportation
_Fort Collins PO Box 580
281 N College Ave
Ft Cotlins, CO 80524
970-221-6760 phone 970-224-6134fax
Commercial Construction Application Information
Revised 03/30/2009
Application Number:
Job Site Address: 4-z)iJo ZI E&LAXL 1? a fay► Ccf—w N5, CO �os2S
New Building Addition
Building owner: Ao,,&v I ecr INr�S
Building owner address: 14;E50 z-le(rt-� "
Building owner phone #: 20&
Name of Business: AU&&o Iec,40"btcS
Remodel-/TF
Proposed Use: (i.e. medical, office, bank, retail, etc) O�c <=
Project square footage: SWO
For commercial remodels & tenant finishes, please answer the following questions:
➢ is the remodel Itena finishes 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? OWNtTL oac-Leteo
➢ Are there any exterior building changes associated with the work? Yes or
If yes, please describe:
Signature of icant
Name (please print)
I I(z��o
Date
Z08 03��
Local daytime phone #