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HomeMy WebLinkAbout2869 Breton Way - Applications/Basement Finish - 08/18/2014City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES For t Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 / www.fcgov.com/building lyq ) p,u 7 BUILDING PERMIT APPLICATION APPLICATION NUMBER t>1 40I (ZLf q APPLICATION DATE CJ'I U"'4 Job Site Address Zg69 -Fre7lyn W !j Unit #. PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # / M y7 Z S6 6 7 Last name_ �iQ tJ&'r ( NK6' ,S First Name L Middle Street Address FP30-k-- 2-066 `` City -f:�dr I 6011" ✓ ,% State 40 zip CONTRACTOR INFO: Company Name 7� I/�N i av1�S Contractor Phone # [g70 417 L 5Yd Lic Holder Name AIA q /)trOPG City of Fort Collins License # 6iz-7 i Supervisor Cert # Mailing Addresspt)i& 7-eo City^.%i, 0�0/111-1 % State 4a zip 5491F22-- LEGAL INFO: Subdivision/PUD I ,t4 Wert FAL-rNLS Filing # Lot # i Z if Block # Lot Sq Ft 6oLZ CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft Residential Sq Ft Comm'I Sq # of Stories Bldg Height # Dwelling Units 1s' Floor Sq Ft 2nd Floor Sq Ft 31d Floor Sq Ft Unfiished Bsmt Sq Ft SZ6 Finished Bsmt Sq Ft?ib # of Bedrooms -/— # of Full Baths _/_ % Baths Yz Baths # of Fireplaces Air Conditioning: Yes No Energy info:( Circle appropriate choice) 1. ComCheck 4�pesCheck w/Air Sealing 3. ResCheck w/Blower Door City of Fort Collins Stock Plan # UTILITIES INFO: 4. Simulated Performance Alternative S. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door 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, material & profit) $ ZZi i 7- Description of Work: Ao Contact Name & Phone # of JOBSITE SUPERVISOR: 04-fta4 Subcontractor Info: � ElectricallP-Aujei-hoeSQ Mechanical�i�rfG � -•Zt /0r7J '�r Plumbing Framer &C " ri c4. Ens* Roofing Concrete Fireplace Solar 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 of F ollins inances and state laws regulating building construction. Applicant Signature Print Name/ //6-0 �Wopc Phone '1705/6 3td sq Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE