HomeMy WebLinkAbout806 W MULBERRY ST - APPLICATIONS - 10/10/2019Art Collins
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COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80524 • Phone: 970.416.2740 • www.fcgov.com/building
BUILDING PERMIT APPLICATION
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FOR OFFICE USE
%PPLICATION NUMBER: 6 l J 1240 APPLICATION DATE: /0. /0./ q
Job Site Address 90(o W f yu I
PROPERTY OWNER INFO: (All owner information is
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red — NOT optional)
Last Name p,-[er� First Name j�2vI
Wr1 Middle
Street Address FOG W iAV1tfry City F;r—F- 6(111n5 State (fO Zip gGSZ(
Phone# g76-Z(9`06i7 Email VdeL_)f2t'Le:9(9
Name Of Business (COMMERCIAL USE ONLY)
CONTRACTOR INFO: Company Name
License Holder Name LIC # CERT #
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (NOT including basement) Total Garage Sq. Ft. 600
Residential Sq Ft Commercial Sq Ft # of Stories Bldg Ht 10 ' # of Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft 3rd Floor Sq Ft Unfinished Basement Sq Ft
Finished Basement Sq Ft # of Bedrooms # of Full Baths
% Baths Y2 Baths # Fireplaces
ENGERGY INFORMATION: (CHECK ONE)
Unit#
ComCheck ❑ UA (ResCheck) ❑ SPA (Simulated Performance ❑ prescriptive❑ ERI(Energy Rating Index) ❑
Alternative)
Air Conditioning? YES ❑ NO
City of Fort Collins Approved Stock Plan # SPO List Option #s
UTILITIES INFO: Gas ❑ Electric )KI Electric Temp. Pedestal Yes ❑ No ❑
Electric Main Breaker Size (Residential Only): 150 amp or less ❑ 200 Amp ❑ Other ❑
ZONING INFO: (COMMERCIAL USE ONLY)
Proposed Use: (i.e. medical, office, bank, retail, etc.)
For Commercial remodels and tenant finishes. please answer the followine auestions:
Is the remodel/tenant finishes for an existing or new tenant? (Please check one)
Existing Tenant❑ New Tenant[:]
If for a new tenant, is this the first tenant to occupy this space?
Yes ❑ No ❑ If not for the initial tenant for this unit, what was the previous use of this tenant space?
Are there any exterior building changes (including mechanical) associated with the work? Yes ❑ No 13
If yes, please describe:
WValue of Construction (materials and labor):
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Description of Work:
JOBSITE SUPERVISOR CONTACT INFO: Name in Qe,,,j6
SUBCONTRACTOR INFO: Electrical r4[(iance— Mechanical
Plumbing
Fireplace
Framing
Solar
Phone q70-2rq-6677
Roofing 6ordo n:7g2y
Other
ASBESTOS STATEMENT DISCLOSURE: In accordance with the State of Colorado Senate Bill 13-15Z property owners, applying for a
remodel permit shall indicate their awareness about their property having been inspected forAsbestos Containing Materials (RCM's).
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I do not know if an asbestos inspection has been conducted on this property.
An asbestos inspection has been conducted on this property on or about (enter date)
An asbestos inspection has not been conducted on this property.
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 ordinances and state laws regulating building construction.
Applicant Signature Type or Print Name rawfx />rn1i�&
Phone# q7p-_00-66-77 Email VdP�&A �8 e 5mgI/, to
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE