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HomeMy WebLinkAbout2139 Lambic St - Applications/Sprinkler - 05/23/201805/24/2018 19 05 520-322-9850 o rt Coll„ ins FEDEX OFFICE 4194 PAGE 10 Planitidng, & TIrling0rt don 281 N College Ave P.0 Box 5W Fort Collins, CO 80524 Phone 970 4WZ740 Fax 224-6134 OVER-THE-COUNTER PERM17S ONLY TWe. arppataftri Is to be use to apply for the folk -no age lrerrel#a only (etPee k all treat apply) 0 Air C:andmcmrng C3 Demolllion (interior non-structural) a EleciftM Ammon (not Service char) 0 Gays Lighter 0 Gas Log 0 HMng Unit ,Lawn Sprinkler 0 Mobile Home replacement Q Roofing O Sewer Line O Photo-voitale © Ventilation O Water Heater Gt Water line 13 Wood/Pallet Stove (must be EPA c erged, provide make. ►nodel and manufacturer) Complete all apolmaable Infbrmatlon on the applicablon. Incomplete applications will not be accepted Application # P-) I � ob 4 0 " � s*b Ske Address megwred) Date �J 9 Value of Cons trucbm (labor, matertals, Pro � GQ Property r Nam Address City/state ZIP Phone klwe� Applicant Name Address Cry/State ilp Phu e elp,..rti 3 .'A- r (ors / Mw- 2.27- f03.o Contra cl:or Address City/stabs Zip Phone Gonbacbor City of Pt. Coilms Sales Tax # Are you paying taxes here or by report? E3 Here 0 Report ow number is too" by a# carrrracws, Are you paying with your trust amount") a Yes Mm Is this a resldenbal or commercial project7 Jived Residenbal 0 Commeroal if Attar, is It- Xsingle Family Detached C3 Ciondo/toHmhome (single family attached) CJ Duplex 0 Multifamily (apartment) Q Garage If commercial, is it E3 Bank 0 Bar 0 Church 13 Hotel/Motel E3 Me[dcai office CJ Ofte C3 Retail El Restaurant Cl Other (explain) Is this building 50 years of age or more? Dyes ,1).$'NO JY yes, )ovu may heed to c moo Hlgott Ptamrwww N this m for a demolition perm*. what year was the building construcWd? 1JFpr' & to I975, }w WE naed an asbastms a mw to submit voM arils Agaftaon DescripUon of work *If iavm Wmftftdftw pre+/l rater, must IISt krod Dumber if first-&N A/C, must list lKemd eleWdan 5ubcontreclborm uFt the av►M,p�Wna/�/mj�e or Ley of fr Co#m /rap w # per_ �y mike, 1UC1 l._l ��'(/V �L Roofer WiGf I hereby ac gwMedge that I have read tfft applrcatiori and state that the above Information Is complete and correct. I agree to comply with all requir a .news anitalned herein and city oNftnoes and state laws regulating building consovicaan. I kngwr drat a parfait Is not valid w111 It has bew paid and isued. (I I)1 S It�at N r� ce�'4. . ,.,.. A F 1 l m signature 4j"-� Date— Sj e