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HomeMy WebLinkAbout438 HOUGHTON CT - APPLICATIONS - 6/14/201306/12/2013 15:02 970-506-2730 ALPINE GARDENS PAGE e8/11 Planning, Development & Transportation 281 N. College Ave P.O, Box 58o Fort Collins, Co ODS24 Phone 970-416-2740 Pax 2246I34 ... OVER-THE-COUNTER •PERRIMS ONLY This application is to W used to apply for the following permits only (check all that apply), ❑ Air Conditioning O Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter O Gas Log ❑ Heating Unit C] Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Une ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Une ❑ 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 .#-BILv09gi o For office crse any Date , iiQ — N-13 Job Site Address (requimd) Value of Construcdon (labDr, malenials, profit) � �(� C7C� -) -�� rU [s% ;>✓'t tom.-►4� !�o _Fe'r»:! ^- Property Comer Name Address Gty/Stakep Phone Name I Address Cdy/State Tip Phone Contractor Address e . Gty/State . zip Phone Contractor City of Ft. Coffins Sales Tax I Are you paying taxes here or by report?'KHene ❑ Report salmi &Wnrmw cfegw4elbyall mrmacros Are you paying with your test account? © Yes ki No ZZzvk Is this a residential or eommerdal project? X Residential ❑ Commercial . If residential, Ls It . E3 Single Family Detached El CondoltmMome (single familyarfached) 0 Duplex U Multifamily (epat}ment) ❑ Garage if cOmmerdal, is It: it Bank ❑ Bar U Church ❑ Hotei/Motel 0 Medical office 13 office L7 Retail ❑ Restaurant . Q Other (explain) is this building S13 years of age or more? . ❑ Yes T No Ifjes. you mayneed io mntadHisfaricPiesvrafion if this. is for a demolition permit, what year was the building constructed? Tfpnorin 1975, you wfi/nead an asba5&w assassment m subm/r wb) d9s application. Description of work *If lawn sprinider/baddiow preventer, must fist licensed plumber, if first trine A/G, must list licensed edeatri6an. Subcontractors. LEttim companyname orGBroffiColJl u11asinse4 p ry Flumbe.' �/# � �,� t7echanidi Roofer Dew i hereby adoiowledge 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 ord'ularim and state laws regubtb)g building mnsbuctton. I know that a permit'tsntrt'wa5dfrnta7it'f��baenipaid'arid:imnecf..... ......... r