HomeMy WebLinkAbout2820 Longboat Way - Applications/Addition or Alteration - 10/03/2011Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 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 (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ 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 #
For office use only
Date Z 3 4011
Job Site Address (required)
Value of Construction (labor, materials, profit)
Z ZO o.16-/ T—
I.JAY
0
*760 0
Property Owner Name
Address
City/State Zip
Phone
L77 elq -t —
S/I't L
i • CxcwS Co dbrz(
o-!PL
Applicant Name
Address
City/State Zip
Phone
429 S Howes St. Fort Collins/CO 80521
970-472-8100
Contractor
Address
City/State Zip
Phone
HighCraft Builders
429 S Howes St. Fort Collins/CO 80521 970-472-8100
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
® Here ❑ Report
Sales tax number is required by all contractors.
Are you paying with your trust account?
❑ Yes ® No
39751
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: ® Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes K No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work &0 LDS Lwr S4 p,&C P/T Aquae_ czr 'nwc az�
Fog_ dhm4Z t- 441-rw C
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/c, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electrician/f S Plumber P f 16K &yO• 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: — { ��(. Signature
Date o 13 Ao