HomeMy WebLinkAbout4380 ZIEGLER RD - APPLICATIONS - 9/17/2014rCity of
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COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 60522-0580 • Phone: 970-221.6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 7B1 y 04F)3'5q APPLICATION DATE
Job Site Address 44�w -?aa=� th. f� LDwo, p �a52S Unit # IH
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last name Ajkno :WNpt�Q(-jEiFirst Name m Middle
Street Address 14;'J7 ' 16�Q— M. City tOF-l' ('CwiNS State Cb Zip
CONTRACTOR INFO: Company Name 'SG `l� t� i�mN54lWc,Tlon1 Contractor Phone # -,03 —_7$ � SC1 3Y
Lic Holder Name City of Fort Collins License # 05- A Supervisor Cert#
Mailing Address 2D:;P S & 4Nb> Qj.Ii�) g011E 120�2- City t)CLAuD�__ State CC) Zip �z?�
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft 5q
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) fNXJ (C 04,u-Wvr) Total Garage Sq Ft N�A"
Residential Sq Ft Comm'I Sq Ft '#-ef-storles. Bldg Heigh! # Dwelling Units _
1 s° Floor Sq Ft IB nGz snS�2n° Floor Sq Ft 53590 6 Ao (� 3rtl oor 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 #
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) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ M .2'1'9 t5G-I . -1-b
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR: (t'tI 1-c l�m'110' 14%o" --T��
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Subcontractor Info: nI� '�
Electrical t a:yc� Mechanical t�L�lf at�^g Plumbing f&L itt lr4r))4J(,
Framer Roofing
Solar �1.iy Other
Concrete
Fireplace
Other E Other tk
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.
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Applicant Signat Print Name CYA CS1r � Phone
�Djstribeton: While -Office Yellow -Applicant Pink -WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE