HomeMy WebLinkAbout613 SKYSAIL LN - APPLICATIONS - 5/28/2013Fort 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 be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable iMhj�J
orm��ionn on the application. Incomplete applica io�nss wiill not be accepted. � �3
Application # wl�V 10 Date
For oflbe use only
lob Site Address (required) Value of Construction (labor, materials, profit)
6/.3 /, ii, I irrc,'� y $ Y 6av', 00
Property Owner Name Address
City/State
Zip
Phone
/11/ E . o r1cma 6)3 skys,9l1'
I - A r<�/c 0.
0S.1
!YX3- 6
Applicant Name Address
Gty/State
Zip
Phone
DE91ji'o 23.1 sin-
1,0v Lx
8053->
66 -_'
Contractor Uc # Address
City/State
Zip
Phone
ceo,*1Z cee,s- ,,
., ,09
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
M Here ❑ Report
Sales tax number is required by allmntrao'om
Are you paying with your trust aamunt?
Yes Q No
Is this a residential or commercial project? IN Residential ❑ Commercial
If residential, Is it: ® Single Family Detached ❑ Condo/townhorne (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? 0 Yes A No If ye& you may need to contact Historic Presser ation
If this is for a demolition permit, what year was the building constructed?
Ifprior to 1975, you will need an asbestas asessumt to submit with this application.
Description of work
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/c, must list licensed electrician.
Subcontractors: List the company name or Gty of Ft Collins license #
E.G,es'r�p
Electrician Plumber Mechanical . Roofer 6;;a4 z q 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
penult is not valid until it has been: paid and issued.
Applicant:
PDate S1a8113
rirntName: l�Q�i,,� ��,s>un.�Lc,�y Signature