HomeMy WebLinkAbout412 E Mulberry St - Applications/Addition or Alteration - 09/07/2018City of I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
. F6 t Collins 281 N. College Ave. • Fort Collins, CO 80524 • Phone: 870-416-2740
www.fcgov comlbullding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER I APPLICATION DATE
. _E_E-___412 F Mulhprry I .r r- /YL .... Ir _ AAS
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,{ (Aht jowner (Infoorm, aatlon Is required - B Is not optional) Phone # `7&0 / 1 q �� � q I 0
Last name I�QIIAz/1e VV (t�Yil�yV First Name �✓Uwyl I Middle
Street Address 3 .}CN VQ1� V� City Ckxdfbo-d StateZip q')0001
CONTRACTOR INFO: Company Name Site Ind/ Basement Escape Contractor Phone #970-227-0789
Lic Holder Name Brian Stephenson City of Fort Collins License # 815 Supervisor Cert #
Mailing Address 519 N Overland Trail cityFC state CO zp80521
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1° Floor Sq Ft 2n° Floor Sq Ft 31" Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths Baths # of Fireplaces
Air Conditioning: Ye�]Nop Energy Info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door ❑ 4. Simulated Performance Aftemative❑ 5. Prescriptive,w/Air Sealing 6. Prescriptive w/ Blower Doora
City of Fort Collins Stock Plan #
List appropriate option #s
Water Tap Size Sewer Tap Size
Type of Heat Gas11 Electric Electric Main Breaker
Value of Construction (including labor, material & profit) $ t/
Metered: Yes F-]NoF-1 Temp. Pedestal Yes❑ No El
e (Residential only) 550 Amp or Less 1:1 200 Amp DOther
Description of Work:
install 1 4W'basernent egress window per code and engineering
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractorinfo:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby cknowledge that i have read this application and state that the above information Is correct and agree to comply with all requirements
contained herein a City of Fort Ilins rdi noes a stat ws regulating building construction.
r yvi�r 61601
Applicant Signa / Print Name 04l -�Tfi�/ VV W�� Phone /
Distribution: White - Office Yellow- Applicant Pink - W W W/Stomnvater q0-(i1Rvr d
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
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