HomeMy WebLinkAbout620 W MULBERRY ST - APPLICATIONS - 10/24/2005BUILDING PERMITS & INSPECTIONS DIVISION
-- _ P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER P✓lJ Ty � 1 APPLICATION DATE I a CS S
Job Site Address IhO�d (,J . U' 14A)f f ro Unit #
PROPERTY OWN R INFO: (All owner information is required — it i tt optional) Phone # "►p
10
Last Name J01 NP.� First Name //Iger.r Middle (IC
Street Address ` , C ti y/ �'8 State Zip O'�
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cert #,
Mailing
LEGAL INFO:
Subdivision/PUD
City
Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
State Zip
Block # Lot Sq Ft &S
Total Garage Sq Ft
Residential Sq Ft
Comm'I Sq Ft
# of Stories Bldg Height
# Dwelling Units _
15t Floor Sq Ft
2nd Floor Sq Ft
Unfinished Bsmt Sq Ft
Finished 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. E-Star w/Blower Door
5. Prescriptive w/Air Sealing
6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
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 (including labor, material & profit) $"? C7d
Description of Work: 10, �✓hCq CA) CSC
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical Plumbing
Framer Roofing Concrete Other
Applicant: I hereby acknowled a I have re this pplication and state that the above information is correct and agree to comply with all requirements
contained herein and City of rt ins ordin es a state laws regulating building construction. I ry
Applicant Signature Print Name 4 ` Phone p `
istr' n: White —Office Yellow — Applicant Pink — WW A tormwater
THIS AP IC
ION EXPIRES 90 DAYS FROM APPLICATION DATE