HomeMy WebLinkAbout2025 W Mulberry St - Applications/Water and or Sewer - 03/27/20125
City of Planning, Development & Transportation
e 281 N. College Ave P.O. Box 580
Colfin5 Fort Collins, CO 80524 .
Phone 9701F16-2740 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 Afteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation 19 Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applic h A information on the 2licatlon. Incomplete applications will not be accepted.
Application # � / )6 _ Date ' � 7
For office use only
Sob site address (frqu%red) Value of CQnstructiop (labor, materials, profit)
1 ZIJZS IN
Property Owner Name Address
City/State' Zip
Phone
Applicant Name Address
City/State Zip
Phone
Contractor Lic # Address
city/State Zip
Phone �i S it
'tee `+c;ir—i c
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Contractor City of FL Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here $Report
Saks tax nvmbarlsrequiredbya#Ca,&
Are you paying with your must account?
IR Yes ❑ No
ZZS�7
Is this a residential or commercial project? (B Residential' • ❑ Commercial
If residential, is it: R Single Family Detached 13 Condo{townhome (single family attached) ❑ Duplex
- ❑ Multifamily (apartment) 0 Garage
If commercial, is i6 - ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel 0 Medical office ❑ Office ❑ Retail
a Restaurant Ci Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Hlstorlc Preservab'on
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 w/th this applicapon.
Description of work
it lawn spnnaer/0acKr1ow preventer, must list licensed plumber. If. first-time A/C, must list licensed electrician.
Subcontractors: L/st the company name or ay off r Collins license #
Becbio'an Plumber Mechanical Roofer Other
1 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
permii6 is not salad unt:t it leas beer. pair: and issued.
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