HomeMy WebLinkAbout4380 ZIEGLER RD - APPLICATIONS - 4/3/2012City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort+t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE I3 I a.o i a
Job Site Address 43 S v Z! Ea I - CAR A. Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Q70 -L8R -- 03'ffi
A Last name UA&C> t KCHA3oL0 ./ES'First Name Middle
Street Address e-13 8.O Zti GS F L45.e 4A City lFV —1 COX [IicJS State Ca Zip 9052-*
CONTRACTOR INFO: Company Name RE4 V C-aA-)-S k0s3o: 0A1 Contractor Phone # C?76 -2 Z1 -�e/ 9 6p
Lic Holder NamekyAAGAC 7(t City of Fort Collins License # Supervisor Cart #
Mailing Address_[{( A4� �(9F % % F G City MQl C'�GL/A�' State CO Zip �0j 2�
LEGAL INFO:
Subdivision/PUD f64jR S FQA3 • kEU-Y ?— Filing # Lot # _ Z Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) �s Total Garage Sq Ft
Residential Sq Ft Comm] Sq Ft # of Stories Bldg Height At # Dwelling Units
15' Floor Sq Ft
Finished Bsmt Sq Ft
2nd Floor Sq Ft
31d Floor Sq Ft
Unfiished 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 #
UTILITIES INFO:
List appropriate option
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) ❑ 1/50 Amp or Less' ❑ 200 Amp El Other
Value of Construction (including labor, material & profit) $ �, 7 v D( S�
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR: GAAY S e2ke 114 ct70 -Z8.8 ^ 40OS'4
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowl ge that I have read his applicatio and state that the above information is correct and agree to comply with all requirements
contained herein and City o ollins or ' a nd state s regulating building construction.
r Applicant Signature Print Name S— ru E- k )&CCmC7 Phone 47y - V-P-A $4?
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE