HomeMy WebLinkAbout1469 Sailcrest Ct - Applications/Mechanical - 02/10/201403-06-14;07:34AM; ;970-484-4448 # 7/ 11
Fort Collins
of
Planning, Development & Transportation
281 N. College Ave P.O. Sox 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (chock all that appiy).r Conditioning
demolition Anterior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Ughtepppppp////// ❑ Gas Log
eating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
entilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application 21-7 Date
Forofil7ce use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
t 1
•no�
a Address
Pr Owner NXas-17:0
City/State Zip
Phone
lon
a A.
Appli6nt Nam Address
Gty/State Zip
Phone
i r'A1 101L. L J AJ
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174- g . &�1l
,Sherrl'
actor Address
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City/State Zip
�� �o g067
Phone
�l�N-ygy!
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
g Here Report
sa/esoxnumber uiredbyallcon&acrors
___ 12
Are you paying with your trust account?
Yes ❑ No
Is this a residential or commercial project? Rest ential ❑ Commercial
If residential, Is It: ❑ Single Family Detached a13 ndo/townhome (single family attached) Duplex
❑ Multifamily (apartment) 0 Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motet ❑ Medical office 0 Office 17 Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No rfyes, you mayneed to aont2FctHist0dcPreservati0n
If this is for a demolition permit, what year was the building constructed?
if poor to 1975, you will need an asbasbs assessment to submit wllh this application.
work
r
*If lawn sprinkler/backflow preventer, must list licersed plumber. If first time A/C, must list licensed electrician.
Subcontractons: Ust the companyname orGty offtWlinsllmnse #
Eledridan Plumber Mechanical 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 requirements contained herein and city ordinances and state laws regulating building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant
Print Name:
Date � 0