HomeMy WebLinkAbout180 W Mountain Ave - Applications/Shed - 01/22/2013�"j10
l�+€{o COMMUNITY DEVELOPMENT S NEIGHBORHOOD SERVICES
fol ` Collins 281 N. College Ave. a Fort Collins, CO 80524 • Phones 970-416-2740
wwmfcgov.cotn&uliding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER. dill /i \� APPLICATION DATE -
Job Site Address 180 West Mountain Avenue Unit #
PROPERTY OWNER INFO: (All owner Information Is required - it is not optioned) Phone # 970-221-6605
Last name MlgChelbrihk First Name Helen Middle
Street Address 281 North College Ave. city Fort Collins State CO Zip 80522 .
CONTRACTOR INFO: Company Name ECI Site Construction Management Contractor Phone #970-669-6291
Lic Holder Name Tony Perdue City of Fort Collins License # CI-2M Supervisor Cent #,3379
Mailing Address PO Box,2135 City Loveland State. CO Zip 8053R
LEGAL INFO:
Subdivision/PUD Filing ,# Lot# Block# Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not induding basement) 162 Total Garage Sq Ft
Residential Sq Ft Comml Sq Ft # ofBtories Bldg Height 15 ft. # Dwelling Units.
1" Floor Sq Ft 2nd Floor Sq Ft 3b Floor Sq Ft Unfiished Bsmt Sq' Ft
Finished Bsmt Sq Ft # of Bedrooms _ # of Full Baths % Baths _ 'S Baths # of Fireplaces
Alr Conditioning;. Yet[]N Energy info: ( Circle appropriate choice) 1. ComCheck 2. ResChecck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative ❑ 5: Prescriptive w/Air Sealing 8: Prescriptive w/ Blower Doom
City of Fort Collins Stock PlaLLLLLnLn 11111 1923 List appropriate option #s
t1TILITIESJNFO:
Water Tap Size Sewer Tap Size Metered: Yes allo❑ Temp. Pedestal Yes No ❑
Type of Heat: Gas Electric Electric Main Breaker Size (Residential only) �150 Amp or Less E1200 Amp []Other
Value of Construction (including labor, material & profit). E 167,500.00
Description of Work:
Mason Corridor Max BRT Project- Earthwork, Foundation, Fabrication/Installation of Stations, Masonry, Pavars
Contact Name & Phone # of JOBSITE SUPERVISOR: Rick Coulter 970-218.4203
Subcontractor Into:
Electrical S turgeon 303-591-9072 Mechanical Plumbing
Framer CMi°"o"rv°"o s30 '3'so Roofing Concrete Co aaeB7°B�Oa'a 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 cornpty with all requirements.
contained herein and City of Fort Collin dinenc acid state laws regulating building construction.
Applicant Signature Print Name Tony Perdue phone 303-503-4767
Distribution: White- Office Yellow - Applicant Pink- WWvV/Stonnwater
THIS APPLICATION EXPIRES`ISO-DAYS FROM APPLICATION OATIE