HomeMy WebLinkAbout4229 BREAKWATER CT - APPLICATIONS - 5/7/2019city of Planning, Developmen4 & ►ransportafion Services
Fort Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO80524 Main: 970.4162740 Fax 970.224.6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Candioning
❑ Demolition (nterior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit P Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation AWater Heater ❑ Water Line ❑ Wood/Pellet Stave (must be EPA certified, provide make, model and
manufacture .
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # QM �)a CIC N Date May 7. 2019
For ofteawa*
Sob Site Address (regdmd) Value of Consteuction (labor, materials, profit)
4229 Breakwater Court, Fort Collins, CO 80525 $2520.00
Property Owner Name Address city/Slate ZIP Phone
Linda/James Truitt 4229 Breakwater Court Ft Collins, CO 80525 561-789-8968
Applicant Name Address city/State Zip Phone
Christina Evans 1015 link Lane Ft Co, CO 80524 494-7632
Contractor Address City/Stacie ziP Phase
Allen Service 1015 link Lane Ft Co, CO 805Z4 484-4841
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? 131Iere ❑ Report
Safes tairnmaberIstavi/adbyagom*aacmrx Are you Paying with your bust aomunt? VYes ❑ No
10010
Is this a residential or Wninercial project? Residential ❑ Commercial
If residential, is it V Single Family Deed ❑ Condo/6ownhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank U Bar ❑ Church ❑ Hotei/Motel ❑ Medical office 13 Office 13 Retail
0 Restaurant ❑ Other (explain)
Is this build'mg 50 years of age or more? ci Yes ❑ No Vie& yw mayneedto contact hBtm* Prsswvatkn
If this is for a demolition permit;, what year was the building constructed?
Description of work P 1 ft "'sf"g `1h ad rco=sa"' new K5 w/h
*If lawn sprinkler/baddbw preventer, must fist licensed plumber. If fwst-time A,/C, must list licensed elechi ian.
subcontractors: ListtlremmpanynameorLRyofftColgrts6cerse
Eledriaan Plunber Medianiol Roofer Other
I hereby acknowledge that I have read this application and state that the above information Is complete and correct. I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
perTmt is not valid rmbl it has been paid and issued.
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