HomeMy WebLinkAbout317 Kalkaska Ct - Applications/Sprinkler - 08/30/201208/30/2012 08:51 970-506-2730
ALPINE GARDENS
PAGE 02/06
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-Z740 Fax 224.6134
O'6�E114'H COUNTER ■ ERMITS 0NLY
This application Is to be used to apply for the following permits only (check all that apply). Ll Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter Q Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Phato-voltaic
❑ Ventilation Cl Water Heater ❑ Water Line 13 Wood/Pellet Stove (must be EPA certified, provide make, model and
manurfacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # Date
For off use only a?_ . 6T
Sob Site Address &Wulreo7 Value of Construction (labor, materials, profit}
Property Owner Name Address Gty/StaEe Zlp Phone
Applicant Name Address Gty/State Z1p Phone
Contractor Address w City/state lip Phone
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? "KHere ❑ Report
.s�t�=byall cent vows Are you paying with your trust account? ❑ .Yes J� No
]s this a residential or commercial project? JK Residential ❑ Commercial
If resldeh al, Es it: ID Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
Q Multifamily (apartment) ❑ Garage
If commercial, is it: A Bank ❑ Bar ❑ church D Hotel/Motel ❑ Medical office ❑ Offfice 0 Retail
0 Restaurant ❑ Other (explain)
Is this building 5o years of age or more? ❑ Yes 7@ No Zfyes, youmayneedto contact Historic Preservation
If this. is for a demolition permit, what year was tite building constructed?
9pi7or to 1975, ytw W//need an as bes=g assersment to submit w1h this app/icatlon.
Description of work
*If lawn sprinlder/badcHow preventer, must list Icerised plumber. If first-time A/C, must list licensed electrician.
SubcontractoM Lfstt5emmpai7ynamear6tvol`RCoI/Insllcmm#
6ecbician PlumberMechanical Roofer Other
I hereby acknowledge that I have read this application and state that the above Information Is complete and correct. I agree to
comply with. all. requkaments contained herein and.dty ordinances and state, laws regul Ig.bunding construction. I know that a
permitis not'valid until Ei has been paid and issued. '��"1