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HomeMy WebLinkAbout419 Tedmon Dr - Applications/Demolition - 01/30/2020For'�t of Planning, Development & Transportation 281 N. College Ave P.O. Box 580 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 C C ❑ Demolition of entire building or residence Complete all applicable information on the application. Incomplete applications will not be accepted. Application # �?7Z_OD P 76 Date 11 �, D /Ze7 z O For office use only cX2 ��� Job Site Addres (required) Value of Construction (labor, materials, profit) 6 Properly Owner Name Address City/State Zip Phone S r` Aicant Name Address City/State Zip Phone �zd j /Iyi �J Contractor Address City/Stat Zip Phone Cl 44 5 ale P 61 'Sr( - Contractor City of Ft. Collins Sales Tax # t 3/6-do sales tax number is required by all contractom Are you paying with your trust account? ❑ Yes Flo Is this a residential or commercial project? 1?1:(esidential ❑ Commercial Is the demolition of an upcoming Development Review project? ❑ �o Yes If residential, !sit: 0 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: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (ex Jain) Is this building SO years of age or more?Yes ❑ 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 footage to be demolished: Subcontractors: List the company name or City Electrician Plumber Collins license # 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 Nam Signature Date F01-3 Fort 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 used to apply for the following permits only (check all that apply). ❑ Air Conditioning dElectrical 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 #, For of oe use only Date lob Site Address ( quired) Value of Construction (labor, materials, profit)9 (�c7 Property Owner Name Address City/State Zip Phone Aicant Name Address City/State Zip le Phone ,f � s 2 3 Contractor Address City/State Zip Phone Contractor City of Ft. Collins Sales Tax # r" ialaD Are you paying taxes here or by report? ZHere ❑ Report Sales tax number is required byall ronbactors Are you paying with your trust account? ❑ Yes ❑ No Is this a residential or commercial project? ❑ 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? Q Yes ❑ No If yes, you mayneed to contact Historic Preservation If this is for a demolition permit, what year was the building constructed? &L of work 0 vC *If lawn sprinkler/back low preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the companyname or City 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. al Applicant: q Print Nam ef✓� / / �t/`c Signature ^ Date CJ U / 7d�