HomeMy WebLinkAbout2601 W Mulberry St - Applications/Addition or Alteration - 04/06/2018City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N College Ave Fort Collins, CO 80522 0580 Phone 970 221 6760
www fcgov corn/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 12 1 AIL ) 41LT I -) APPLICATION DATE y11111
Job Site Address Zlo j/ WFCST HULA Fle- .1/I
PROPERTY OWNER INFO (All owner information is required - it is not
optional) �P/hone # 91
Last name Pn�a.)c-jQiC /�� cFirst Name V �- ��N V /! Middlek—1 C� �j j�
Street Address d&(9 , 4Y/UL t c� City 11�►27 (_.ULL� State 6 ZiprXJ5z)
CONTRACTOR INFO Company Name t ( f nS7�tG� Contractor Phone # 7O 91 i
Lic Holder Name U4 1� 100&-- f cu City of Fort Collins License # Supervisor Cert #
Mailing Address I �tp ( Uses t (aj City Fo y f C 6 /f AS State C u Zip S- C>
LEGAL INFO
Subdivision/PUD Filing # , / 2 Lot # Block # Lot Sq Ft
CONSTRUCTION INFO Total Bud�7 Building Sq Ft (not including basement) 3& i/ Total Garage Sq Ft Q
Residential Sq Ft Comm I Sq Ft # of Stories Bldg Height # Dwelling Units
1 ' Floor Sq Ft
Finished Bsmt Sq Ft
Air Con6tiomng Yes No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
2 d Floor Sq Ft
3 d Floor Sq Ft
Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths V11" '/2 Baths # of Fireplaces
Energy info ( Circle appropriate choice ) 1 ComCheck 2 ResCheck w/Air Sealing
4 Simulated Performance Alternative 5 Prescriptive w/Air Sealing 6 P escriptive w/ Blower Door
List appropriate option
UTILITIES INFO _% ,�
Water/Tap Size Sewer Tap Size �� Metered\es o No Temp Pedestal Yes o No
Type of Heat )xGas ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor material & profit)
Description of Work
Contact Name & Phone # of JOBSITE SUPERVISOR
L.11-1�
Subcontractor Info % _% / j / /�
Electrical v / P-/�CCT/'r C Mechanical C� rQ� f t a Plumbing N't, 52r �t�t�h U ^,-ie
Framer-b041&�oofng I) )L Concrete Hess' GntiC 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 Fo ollins ordinanc and7sttte laws regulating budding constrr�ucc"tionn / /Applicant Signature 7C Print Name 12:#t-j Riao,--x �i R 4.� Phone �/ ?c7 (� 209�
Distribution White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE