HomeMy WebLinkAbout3307 Oregon Trl - Applications/Plumbing - 09/04/2018,.FCity of Planning, Development, & Transportation Services
ort Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 Fax: 970.224.6134
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 Sprinkle ❑ Mobile Home replacement El 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 # e) 116 D 11 LA S Date September 4, 2018
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
3307 Oregon Trail, Fort Collins, CO 80526 $5000.00
Property Owner Name Address City/State Zip Phone
Jeffrey/Katherine Reynolds 3307 Oregon Trail Fort Collins, CO 80526 970-223-4601
Applicant Name Address City/State Zip Phone
Christina Evans 101 S Link Lane Ft Co, CO 80524 494-7632
Contractor Address City/State Zip Phone
Allen Service 101 S Link Lane Ft Co, CO 80524 484-4841
Contractor Clty of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑pere ❑ Report
Sales tax number lsnequimdbyall contracibm Are you paying with your trust account? VYes ❑ No
10010 ,
Is this a residential or commercial project? Residentlal ❑ Commercial
If residential, is it: V Single Family Detached ❑ Cando/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel 0 Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you mayneed to contactHlstoric Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work 3/4 inch water line replacement from the curb stop to the water meter in the home - approx 50 ft long.
No work being completed in the right away.
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
subcontractors: List the company name or aty offt 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: Signature \t �Vil Date q 1 i U
Print Name: Christina Evans
RONS'.w dale 2W2017