HomeMy WebLinkAbout664 BREWER DR - APPLICATIONS - 9/4/2007BUILDING PERMITS 8L 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 APPLICATION DATE
Job Site Address 1( q g g2ewcy- rip, Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone d3e-3)
Last Name 6-7 /467-6- e � First Name -,1-0e e/* Middle
Street Address 6 6 y lSl�wE`i: �2 City Faar (-%LLr/vS State Co Zip S Lyl
CONTRACTOR INFO: Company Name 010AJEC Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cart #_
Mailing
State
LEGALINFO:
Subdivision/PUD lffUe2 6 ZCPJ Pik Filing # -Zrof7 Lot #-_ Block #_ Lot Sq Ft % 365-
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) It �5 7 Total Garage Sq Ft y 6 o
Residential Sq Ft It 3 S% Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1•t Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft 64 3 Finished Bsmt Sq Ft
# of Bedrooms 3_ # of Full Baths Z- % Baths %: Baths # of Fireplaces
Air Conditioning: es No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
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): ❑ 11150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ r/ (Qq
/", S /-( V-7n.2 !/ti (- C c/ 4E
< L-oSET ArvA S/IAce-
Contact Name & Phone # of JOBSITE SUPERVISOR: ZUF 4�?(A ZE 00-3-) )/ 0 %6 Z6
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
Other
Applicant: I hereby acknowledge that I h ve read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collin rdin nces d sta laws regulating building construction. [
Applicant Signature Print Name N Imo- ` LW Phon(�00 7/0 - 16?�-6
Distribution: Whit -Offce Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE