HomeMy WebLinkAbout4775 BOARDWALK DR - APPLICATIONS - 7/28/2014City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER N `6 D l/ q APPLICATION DATE
Job Site Address�1 ��Gra .r.�� Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # � 2 7- /7y1
Last name U n(� First Name 4�yld�% Middle t&ii
Street Address .4�� ��iej Jt City NAV?/ State Co zip 0 J
j ,y
CONTRACTOR INFO: Comnanv Name (_/p� ,9_ff �Jf 641)11W AA Contractor Phone # 707- ,1 o- /912
Lic Holder Name .11;}ST �u/5�n f t City of Fort Collins License # Supervisor Cert #
Mailing Address S-7b ®tL Ptcl�l✓,, *14f �V City A L State CD zip ®rl
LEGAL INFO: m
Subdivision/PUD (i/t Jn lqjl�Filing # Lot # - Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 10i0DO Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft IoiDA) # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft f�� 2nd Floor Sq Ft
31 Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths t '/< Baths /z Baths # of Fireplaces
Air Conditioning: Ye No Energy info: ( Circle appropriate choice) 1. ComCheck 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 #
UTILITIES INFO:
List appropriate option #s
Water Tap SizeI
I& Sewer Tap Size z I � Metered Ye or No Temp. Pedestal Yes or No
����,,,,rrrr
Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp o Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
Description of Work: c rJll.S l�ii%��c 6. lud l ? r 4 15J1�'Itaut A SlS1
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
/ %.3 L
Plumbing
Fireplace
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 Fort ColliwwRQ
ordinaanncces and state laws regulating building construction.
Applicant Signature �'�b& Print Name AA11 Rt',�+,}�LI/1 Phone 0 7
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE