HomeMy WebLinkAbout323 WHEDBEE ST - APPLICATIONS - 3/19/2007City of fort Collins Building and Zoning Dept. P.O. Box.580 Fort Collins, CO 80522
Phone 970-221-6760 Fax 970-224-6134
City of fart col�701ns OVERmTHROUNTER PERMITS ONLY
Use this application to apply for a permit for any of the following: (check all that apply) ❑ air conditioning, ❑ demolition
(interior non-structural), ❑ electrical alteration (not service change), ❑ gas lighter, ❑ gas line, ❑ gas log, ❑ heating unit,
❑ lawn sprinkler, ❑ mobile home replacement, 0`roofing, ❑ sewer line, ❑ ventilation, ❑ water heater, ❑ water line,
❑ wood stove (*provide model name & number).
Complete all areas of the applications that are applicable to your permit request - Incomplete applications will not be
accepted. An over-the-counter permit will only be valid when it has been paid -in -full and issued.
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Application # o 70/ S q O
to
<2� 7 COWO /Si of
(for office unse only)
Property Owner Name Address
i1p Phone
J o,,e- N P, c, 323 LJ "
8052q 4g2- (i W L
Applicant Name Address
2 ) P Phone
' 1
Name City Lic #. r(-73 Address
Phone
^Coon`trractor
�D.... ����c Z631 S. L-'_�
if 7 - I9 49q-c7,4
Contractor City of Ft. Collins sales tax # 3f-7-Z-? Pay taxes here? ❑ Yes $f No
Sob Site.Address
Value of Construction (labor, material, profit)
3 2-3 L JV. c_k
Is this a residential project? JZ Yes ❑ No
If residential is it: ;E1, Single family detached ❑ Condo/Townhome (single family attached)) ❑ Duplex
❑ Multifamily (apartment) 'd Garage
Is this a commercial project? ❑ Yes ffl'No
If commercial is it: ❑ Bank ❑ Bar ❑ Church ❑. Hotel/Motel ❑ Medical Office ❑ Office ❑ etail
❑ Restaurant ❑ Other(explain)
Is this building 50 years of age or more? ,21 Yes ❑ No
00 c*-Q�s
If yes, you may need to get historic preservation approval prior to permit issuance.
Description of Work �---�— +.nAl
CY les 3fl
**If lawn,sprinlder/backfiow preventer installation, must list -licensed plumber.
If first-time A/C; must list licensed electrician.
Subcontractors: (list the contractor company name or license #)
Electrical Mechanical Plumbing
Roofing R- 73 Other
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements contained herein and city ordinances and state laws regulating building construction.
Applicant:
Print Name morn ��aWN Signatures a--- Date Mom(