HomeMy WebLinkAbout2351 Busch Dr - Applications/Demolition - 06/27/2014F,\orof
t 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 # -F)1403-z� I 1 Date 6/27/14
For office use only
Job Site Address (required)
2351 Busch Drive
Value of Construction (labor, materials, profit)
Demo Estimated alue-$100,000
V
Property Owner Name Address
City/State Zip
Phone
Anheuser-Busch, Inc.
Applicant Name Address
City/State Zip
Phone
Contractor Address
City/State Zip
Phone
Heath Construction 141 Racquette Dr.,
Ft Collins, Cc 80522
970/221-4195
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
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
El Restaurant ❑ Other (explain)
Is this building 50 years of age or mare? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed? See attached abatement
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work Demolition for remodel of AB Brewery Experience building
*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
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: (/�I�j �1
Print Name: T9A 11 /Q 5
Date