HomeMy WebLinkAbout2157 Saison St - Applications/Sprinkler - 08/29/2018City of planning, Development & Transportation
F®281 N. College Prt Collins Fort Collins, COAve 80524 .0. Box 580
Phone 970-416-2740 Fax 224-6134
®VEWTHE-COUNTER PERMITS ONLY
This application Is to be used to apply for the folloeving permits only (check all that apply). D Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter' 0 Gas Log
❑ Heating Unit ,Lawn Sprinkler ❑ Mobile Home replacement O Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line 0 Wood/Pellet Stove (must be EPA certified, provide make, rnodel and
manufacturer).
Complete all appNcable Inffoormation on lthe appiic�on.
V b
Application # Oy �`'�
Porofte use only
Incomplete applications will not be accepted.
Date
Sob Site Adrerm (requlrnd)
value of construction (labor, materials, Profit) ,
i sADM
�s rb, %SPS
Property Otper Name
Address
Gty/State ZIP
Phone
Applicant Name
Lv..Isr,ne �OnC�Prj
Address
SL +s. J
City/State Zip
/:-i $0"/
Phone
970-227- fe30
contractor
Address
City/State Zip
-
Phone
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
saes W number Is required by as conoaca rs.
Are you paying with your trust account?
0 Yes )$No
Is this a residential or commercial project? Q Residential ❑ Commerdal
If residential, is it: MSingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
Q Multifamily (apartment) ❑ Garage
If Commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant 13 Other (explain)
Is this building 50 years of age or more? ❑ Yes ONO If yes, you may need to contact Hlstoricprweryatlon
If this Is fnr a demolition permit, what year was the building constructed?
Yprlor to 1975, you W11 need an asbestos assessment to submit Wffi this application.
Description of work
u lawn spnrnaegoatyUww preveribel, must fist IlCetised plumber. If ftr5t time AJC, must list licensed elect7idan.
Subcontractors: Last the company name cr City of tt 07##K 1lcense #
Electrician Plumber Arp 00 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 Gty ordinances and state laws regulating. building construction. I know that a
permit is not valid until It has been paid and issued.
Appliaant: