HomeMy WebLinkAbout4380 ZIEGLER RD - APPLICATIONS - 9/30/2014City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221- 760
5 www.fcgov.com/building
l/ BUILDING PERMIT APPLICATION
APPLICATION NUMBER/ LZ 2gAq APPLICATION DATE ✓���
Job Site Address 14350 ?SIG-G-LV— eID Fc caraw5• Cn 93LY,-2S Unit # 81
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone
Last name_ _ AV7z� -VQU t Dh163 First Nam
Street Address HS'bp -Zti� 4b. City V--(-- C(x LtNS
Middle
State 60 zip PQS-Zr
CONTRACTOR INFO: Company Name �t;��tJt� Qf2;%C-Tfo,J Contractor Phone #3'
Lic Holder Name City of Fort Collins License # ' 2G' • Supervisor Cent #
Mailing Address 7b S Cau� "M 4) (2W;' City rht�sIdbrz— State /,o zip W22Z
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 2l� Sf Total Garage Sq Ft
i
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height �3�& # Dwelling Units
1 s' Floor Sq Ft �1lOcb 2nd Floor Sq Ft a, lob 31 Floor Sq Ft
Finished Bsmt Sq Ft
Unflished Bsmt Sq Ft
# of Bedrooms # of Full Baths '/< Baths '/2 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, -f4-,or, yiaterial &
/(o_A/loin , oZ ,:
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Subcontractor Info:
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Electrical aa1m, Mechanical U5 D"Uawell& , Plumbing fflaf(s 1'L'UN -j"Ic
Framer Roofing Concrete rj/P Fireplace K((>
Solar N f/� Other s Other W&pc Other Q RgJt5-
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. ''66
Applicant Signature - Print Name Phone -(,2e>
striiiution: White — Office Yellow — Applicant Pink — WWW/Stormwater
APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE