HomeMy WebLinkAbout4380 ZIEGLER RD - APPLICATIONS - 7/22/2015COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort of
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building L
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BUILDING PERMIT APPLICATION R) i
APPLICATION NUMBER + i �� I — 1 APPLICATION DATE
Job Site Address'�/3 7Sjo ;71ECL_gA kA Unit #
PROPERTY OWNER INFO: (All owner information is required -it is not optional) Phone # Q 7 !-o - Z R k
Last name AUf9,rO 2�'r AJQL-r7Glx'SFirstName Middle
Street Address `iAlire ZI F.GLFd lea City -FoA i C®LLL42.S' StateCo Zip.e
CONTRACTOR INFO: Company Name j d+ C.ZAJ-S t1Qt7CltV A L%ntractor Phone # 9170 - 2 ? ^ SF / Qi i
Lic Holder Name 1 i City of Fort Collins License # A3�y&Z Supervisor Cert #
Mailing Address /y1_ _&rQi2J= i ' /i Q City Q� C,rJt�.,� 5' State Co Zip 8'051Z'i
LEGAL INFO:
Subdivision/PUD T'lec S10w7 -Le/1 x Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION_ INFO: Total Building Sq Ft (not including basement) �g0 -.-[ Total Garage Sq Ft lu�p4
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height " tom' # Dwelling Units A2M
1" Floor Sq Ft "rY 9 a 2rd Floor Sq Ft V Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths - % Baths '/ 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 # List appropriate option #s
UTILITIES INFO:
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
0.0 t"
Value of Construction (including labor, material & profit) $,` Q
Description of Wo
Contact Name & Phone # of JOBSITE SUPERVISOR: r0 F%n) rS1 Or S G cL7o -S(. 7- O1,Yz 47a -2�8-3229
Subcontractor Info:
Electrical `/ FGECIe1e Mechanical
Framer
Solar
Roofing
Other
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 o ort Collins ordin ces and staI laws regulating building construction. q 70 —2Z 1 ^</ /9'S
Applicant Signature Print Name,
4Si rs, t&DcC_ Phone%O"E(67-t!y Q
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
Community Planning and Environmental Services
Building and Zoning Department
Citv of Fort Collins
Commmercial Construction Application Information
Revised May 10, 2000
is _� : . -, �:✓ � i = ' v `...,
Application Number:__
Job Site Address: 9/.3 ko Z1z'e'"dd *OA Unit Y
New Building k Addition Remodel/TF
Name of Business: AVACz) % ceY,�
Proposed Use: (Le. medical, office, bank, retail, etc) ;�,.2S;4„4 4-
Project square footage: -,I 9,o Se er-f,
For commercial remodels and tenant finishes, please answer the following:
❑ Is the remodel/tenant finish for an existing tenant or new
tenant?
If for a new tenant, is this the first tenant to occupy this
space?
o If not the initial tenant for this unit, what was the previous use of this
tenant space? (If known)
❑ Are there any exterior elevation changes associated with the
work?
Describe:
Signature
Simy,E f� 4QA .= CC H12)
Name (Please print)
7—ZZ.--IS
Date
4 70
Local daytime phone