HomeMy WebLinkAbout1421 W Elizabeth St - Applications/Demolition - 01/02/2019of Planning, Development & Transportation
City
F _ rt Collinsor N. College Ave P.O. Box 580
Fv-�(`�'r"' t , 1 Fort Collins, co 80524
Phone 970-416-2740 Fax 224-6134
DEMOLITION PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply).
❑ Demolition -interior non-structural
❑ Partial Demolition of existing building
emolition of entire building or residence
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # Z.l $11054 Date
For office use only
Job S to Address (required) Value of Construction (labor, materials, profit)
71 Lo i 3
Property Owner Name Address City/State Zip
Phone
Applicant Name Address City/State Zip
Phone
Contractor Address 3 J City/State Zip
I
Phone
Contractor City of Ft. Collins Sales Tax #
sales tax number isrequieddbyall conrractors Are you paying with your trust account? ❑ Yes
No
Is this a residential or commercial project? ❑ Residential 'I Commercial
Is the demolition of an upcoming Deve%mentRev/ewproject? ❑ Yes O No
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage: Square footage if detached
Number of dwelling units to be demolished:
If commercial, is it; Cl Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
X Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes 0 No
Type of New Building Planned: ❑ Single Family Detached ❑ Condo/townhome (single family attached)
❑ Multifamily (apartment) ❑ Duplex ❑ Detached Garage ❑ Commercial Mixed -Use Building
Description of work
Square foots a to be
Subcontractors: IJ.st the company name or G'ty 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:
Print Name: Cl).Y iW Signature
Date
I