HomeMy WebLinkAbout700 Breakwater Dr - Applications/Addition or Alteration - 07/12/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER ` � IJ C� APPLICATION DATE
Job Site Address
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #��(p — 3L
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Last Name C—t1tiJ First /N-ame /I Middle
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Street Address 00 13/'z'Cc k e-c,cLjC_r"' city _ State (fO zip
CONTRACTOR INFO: ` Company
Lic. Holder Name C n /N sO ti
Mailing Address_a[
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LEGAL INFO:
Subdivision/PUD
Contractor Phone # f?a .Soc.�S��
City of Fort Collins License # Supervisor Cert #
City J!��2� Z" Statezip .
Filing #.
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft
15t Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Lot # Block # Lot Sq Ft
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Total Garage Sq Ft
Comm'I Sq Ft # of Stories Bldg Height _ #Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths % Baths 1/2 Baths # of Fireplaces (�
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing I�
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door 1
Water Tap Size Sewer Tap Size
Type of Heat: ❑ Gas ❑ Electric Electric Main
Value of Construction (including labor, material &
Contact Name & Phone # of JOBSITE SUPERVISOR:
List appropriate option #s.
Metered: Yes or No Temp. Pedestal: Yes or No
Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
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Subcontractor Info: I P Q / J /
Electrical /C_ /1 C/l1 iil /� f� Mechanical r1 r 0uQ/1� (%# //may Plumbing kUaA-14 { P/4"ap/�
Framer C O )r�(iA Roofing N %/T Concrete 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 of ForhCollins ordinances and state laws regulating building construction./j` �^/ 7 p
Applicant Signature Print Name r lv';74 Phone J(�!'��..S3
Di r' ution: tte -Office Yellow - Applica Pink - WWW/Sta�p ter
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THIS APPLICA ION EXPIRES 90 DAYS FROM APPLICATION DATE