HomeMy WebLinkAbout4380 ZIEGLER RD - APPLICATIONS - 9/19/2016City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970-416-2740
/111'� www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER <1_ 11 (U O C5'4 11(1 APPLICATION DATE 9 — I C- I — 11,0
Job Site Address 4380 ZIEGLER ROAD, FORT COLLINS, CO 80525
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone
Last name BELLO First Name MICHAEL
Street Address 4380 ZIEGLER ROAD
CONTRACTOR INFO: Company Name TBD
Lic Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
Unit #
970.566.4541
Middle
city FORT COLLINS
Contractor Phone #
City of Fort Collins License #,
City
State
Filing # Lot # Block #.
State CO Zip 80525
Supervisor Cert #.
Zip
Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 872 Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft 872 # of Stories 1 Bldg Height # Dwelling Units
151 Floor Sq Ft
2"d Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths 3/ Baths '/2 Baths # of Fireplaces
Air Conditioning: YeS Non Energy info: ( Circle appropriate choice ) 1. ComCheck ❑✓ 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Alternative❑ 5. Prescriptive w/Air Sealing F] 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size TBD Sewer Tap Size TBD Metered: Yes ❑NoF-1 Temp. Pedestal Yes❑ No
Type of Heat: Fv] Gas1-1 Electric Electric Main Breaker Size (Residential only) D50 Amp or Less 11 200 Amp Other
Value of Construction (including labor, material & profit) $
170,000
Description of Work:
872 SF ELECTRONICS PRODUCT TESTING LAB SPACE ON THE THIRD FLOOR WITHIN AN EXISTING 3-STORY BUILDING,.
IT IS LOCATED ON THE BROADCOM CAMPUS IN FORT COLLINS, COLORADO.
Contact Name & Phone # of JOBSITE SUPERVISOR: MIKE BELLO, THE CPI GROUP; 970.566.4541
Subcontractor Info:
Electrical TBD
Framer
Solar
Mechanical TBD
Roofing
Other TBD
Concrete
Other
Plumbing TBD
Fireplace
Other
Applicant: I hereby acknowled a 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 Fort of ins ordinances and state laws regulating building construction. �o
Applicant Signature Print Name 1'M Q—�CC�E% Phonecl-to- "IS -1220 Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
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'City ®f Planning, Development and Transportation
Flirt Collins PO Box 580
281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134 fax
Commercial Construction Application Information
Revised /30 2009
Application Number:6
Job Site Address: 4380 ZIEGLER ROAD, FORT COLLINS, CO 80525
New Building
Building owner:
Addition
BROADCOM
Remodel/TF 872 SF
Building owner address: 4380 ZIEGLER ROAD, FORT COLLINS, CO 80525
Building owner phone #: 4380 ZIEGLER ROAD, FORT COLLINS, CO 80.525
Name of Business: BROADCOM
TECHNOLOGY PRODUCT
Proposed Use: (i.e. medical, office, bank, retail, etc) TESTING LAB
Project square footage: 872 SF
For commercial remodels Et tenant finishes, please answer the following questions:
➢ Is the remodel/tenant finishes for an ' cle answer)
existing tenant or new tenant? (EXISTING OWNER; NEW DEPT.)
➢ 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? CDor No
If yes, please describe:
NEW HVAC EQUIPMENT AT THE ROOF WILL REQUIRE A ROOF
ignature of applicant! AGGW-t r-OK DIWAV""A JLTV• Date
LZA i �Fz�F
Name (please print) Local daytime phone #