HomeMy WebLinkAbout910 W MULBERRY ST - APPLICATIONS - 2/24/2009BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
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City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER \rah 1 IO APPLICATION DATE
Job Site Address./y /2 • &LdLeiee S -- ram' q`6
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 7� 7-
Last
Name rei/S 5 / //►First Name 6eO/'7/'`� L Middle
Street Address // 'n7fi / 0,6 /<fg d City►/)lL [_1,6 %2SJ akq State V Zip r?3/8�
CONTRACTOR INFO: Company Name-Rnf1l�,i/y (ELLS —10W �ntrad � en # � � %� Ef�'o2-®Q
Lic. Holder NameeJ , jgRyl/DLy Re-/II116,' City of FortCollinsLicense #-D- 1? 7 Supervisor Cert # `�L!
Mailing Address P® � fC g'% City % Cat, aI4/ s State 4:0 Zip �O�9 � p�/6
LEGAL INFO:
Subdivision/PUD J/ �`�CNU)00 0 rT / S Filing # Lot #--7— Block # Lot Sq Ft (v1744<P
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Total Garage Sq Ft
Residential Sq Ft le-� Comm'I Sq Ft # of Stories_ Bldg Height # Dwelling Units
1st Floor Sq Ft AD2nd Floor Sq Ft Unfinished Bsmt Sq Ft J�a Finished Bsmt Sq Ft
# of Bedrooms .3
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
# of Full Baths -7- 1/4 Baths '/2 Baths # of Fireplaces i
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option #s
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
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): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction ((i�incll�uding labor, material & profit) $
Description ofWork:jJ t e/l?MVZ_
4-.,? --,7- 423 7-176 C- Iea. L'a,�'ess %�/��/,OoaJ - f2, e p �a�� a .�
U,) da) 5
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: Electrical/'Hef1J u,,y �°b kId, Mechanical 811#64 14'44 Ll
A&-7Ct1_1 Plumbing(
Framer Roofing Concrete 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 Collins ordijMces and state laws regulating building construction.
/Lhw Applicant Signature Print NameAx' Phone -4?2- 911119
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE