Loading...
HomeMy WebLinkAbout6121 Claire Ct - Applications/Plumbing - 02/10/2020Planning, Development &Transportation COCity of 281 N. College Ave P.O. Box 580 _! rt Collins 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 ❑ Electrical Alteration ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Sewer Line ❑ 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 # �t%0 I� Date For offlce use only Sob Site Address (required) Value of Construction (labor, materials, profit) Property Owner Name Address City/State Zip Phone J i Applican Nam Address City/State Zip Phone Contractor Address City/State Zip Phone Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ ReRort Sales tax number isrequiredbyall contractors. Are you paying with your trust account? ❑ Yes D_N6 Is this a residential or coT rcial project? Q'(tesidential ❑ 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 ❑ Restaurant ❑ Other (explain Is this building 50 years of age or more? ❑ Yes o If yes, you may need to contact Historic Preservation If this is for a demolition permit, what year was the building constructed? Description of work *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 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: ��nwh �/��I.in� Signature Date �`f 'ZL7 ii