HomeMy WebLinkAbout1801 S College Ave - Applications/Demolition - 02/29/2012r.+.� Planning, Development & Transportation
,„�"",.y }Of 281 N. College Ave P.O. Box 580
I l Collins Fort Collins, CO 80524
� "�� Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
ois application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
emolition (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 # � � Ecdio`
For ofAce use only
Date 2' L9 -y`
Job Site Address (required)
Value of Construction (labor, materials, profit)
/601 5. JAvE
# 11 750. o0
Property Owner Name Address
City/State Zip Phone
LF-STER?t. A N t
l E 1181jJ% Co 8052 (o )
Applicant Name Address
City/State Zip Phone
OD Aldo io
C Fr &ttams Co 96TD7 070;04-oloo
Contractor Address
City/State Zip Phone
NZAADTA r4ir2G 00 lmtJvY417#iJ Dt & G F7 eh"Jois co &0521 A7o dl -p j OO
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here ❑ Report
sales tax number by all contractors.
R
Are you paying with your trust account? ❑ Yes ❑ No
Is this a residential or commercial project? ❑ Residential 9commercial
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 ORetail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes XNo If yes, you may need to contact Historic Preservation
If this is for a demolition permit, .what year was the building constructed? 19'70 's
Ifpnor to 1975, you will need an asbestos assessment to submit with this application.
Description of work 'Dr-mo of fKTEi io0- 9t y e_ wRL-t.-S
*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 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: C"" / Print Name: DfQ6K (',oNEr) Signature f Date Z