HomeMy WebLinkAbout425 W MULBERRY ST - APPLICATIONS - 6/30/2011city
}of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rt Collins 281 N. College Ave. • Fort Collins, CO 80522.0580 • PhoneE 970-221-6760
- www fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATIONNUMBER R//D J `� — - APPLICATION DATE
Job Site Address _ `J3,5 W ._.y,1 �-rV Unit #
PROPERTY OWNER INFO: (All owner information is required It is not optional) Phone #
Last name �1t��2� v. i C•� L ' first N e \4.O I Z \'j ' ^% S
Street Address Ai 00-1 �ity� _ _ _ _ _ State_ t-6 - Zip �5-
CONTRACTOR INFO: Company Name
c _ "�,�1��..,� � � Contractor Phone # ZZ..,�_ • � � _ _ _
Lic Holder Name ity of Fort Collins License # Supervisor Cert #
Mailing Address _ 210k City V— State. C_O Zip lbO S^Z
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 I V5 V # of Stories? Bldg Height ___ __ -_ _ # Dwelling Units
1 st Floor Sq Ft
Finished Bsmt Sq Ft
211tl Floor Sq Ft _ _ ._ 3b Floor Sq Ft Unfiished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes 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
- -MM
Water Tap Size Sewer Tap Size . Metered` Yes or No Temp. Pedestal Yes or No
Type of Heat: Gas E E.lectric Electric Main Breaker Size (Residentialonly)❑ 150 Amp or Less 7 200 Amp 0 Other
Value of Construction (including labor, material. & profit) $ 3 1-1
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical _- (i o_� g hani I /J-16- p Plumbing Framer Roofing Concrete 9y ��4-= Fireplace o k
Solar �� Other r—` Other Other
.Applicant I hereby acknowledge that I hay read this ton and state that the above information is correct and agree to comply with all requirements
contained herein and City of For(gola ord�ces a s laws regulating building construction.
Applicant Signature �--Int Name 61_ _ Phone ZZ 17 gm
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
F®r t Collins
Planning, Development and Transportation
PO Box 580
281 N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-224-6134fax.
Commercial Construction Application Information
Revised 03/30/2009
® 3 ®
Application Number:
Job Site Address: 5 W Jr- -
New Building _ Addition m F
Building owner:
Building owner address:
Building owner phone #:
Name of Business:
Proposed Use (i.e. medical, office, bank, retail, etc) Low
Project square. footage:
For commercial remodels It tenant finishes, please answer the following questions:
Is the remodel/tenant finishes for a se- ctrc answer)
existing tenant or new tenant?
➢ if for a new tenant, is this the first tenant to occupy this space? Yes or No
if not the initial tenant for this unit, what was the previous use of this tenant
Space? - -S " c--.2- -- -
Are there any exterior building changes associated with the work?
If yes, please describe:
Yes
o DNo
Name (please pnnt) Local daytime phone # .