HomeMy WebLinkAbout4380 ZIEGLER RD - APPLICATIONS - 7/29/2015City of
Fit Collins
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER B 15c) S(ab I APPLICATION DATE —1 -a1 — 15
Job Site Address `7' Y- O Z—,r g1enr &4 Co Unit # PROPERTY OWNER INFO_ (All owner information is required - it is not optional) Phone #T=2 D p
- O-?yX
Last name 4Vaa,9 /P_cl�.f First Name Middle
Street Address G/ yv ?„,94,1 - 94 City State C Zip PF2
CONTRACTOR INFO: Company Name 4 Contractor Phone #
Lic Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION_ INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft ZtiG O # of Stories / Bldg Height % 7 -O r # Dwelling Units
1s' Floor Sq Ft 2nd Floor Sq Ft 31d Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/4 Baths '/2 Baths # of Fireplaces
Air Conditioning Yes No Energy info: ( Circle appropriate choice ) 1. ComChe k 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
Value of Construction (including labor, material
& pro/fit) $ ( 0Q"QU0
Description of Work: �i7r ���" Of- j .S-7'Dr / Atasorr0,ix i/�i�•y
Contact Name & Phone # of JOBSITE SUPERVISOR: CMG / /l- j7p 1466/
Subcontractor Info:
Electrical % A Mechanical Plumbing
Framer % 9//z Roofing % /3.* Concrete i tS.A Fireplace i ai
Solar i da Other Other 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 ofyFoo C Ni s ordinances.and state laws regulating building construction.
Applicant Signature ( '�/� Print Name ���/"%� Phone
Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
F6City Of Planning, Development and Transportation
1 t CoWns PO Box 580
281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134 fax
Commercial Construction Application Information
Revised 0 B
3/30/,�0099
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6�
Application Number: >/
Job Site Address: `i zf ' /� - %2Jr
New Building Addition
Building owner: Aya� o —le
Building owner address:
Building owner phone #:
Name of Business: /`/-d a4o
Remodel/TF
c,7/
Proposed Use: (i.e. medical, office, bank, retail, etc) ChP M , I!sq4 JAe:�AP
Project square footage: `170 0 2
For commercial remodels Et tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an (please circle answer).
(4existing tenant 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?
➢ Are there any exterior building changes associated with the work? es No
If yes, please describe: 7 e fjgV oti /.r 6n - IPe Ho"K J;Ve
Grp RC/)'1c%i44A �j aAI llwi ltaLl &Y X,,, l 1F A ai-,-n
�O
Signature of applicant
CA4'G%
Name (please print)
% ��-2Z 5
Date
_ S 70 �Q2 :] 6�
Local daytime phone #