HomeMy WebLinkAbout451 HOUGHTON CT - APPLICATIONS - 6/14/201306/12/2013 15:02 970-506-2730
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ALPINE GARDENS
PAGE 10/11
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, 00 80524
Phone 870-41&2740 Faa 224-6134
..OVER-Tf E-COUR�TER-PERkliTS ONLY
This application is to be used to apply for the following permits only (check all that apply), 0 Air Conditioning
❑ Demolition (interior non-structural) CJ Electrical Alteration (not service change) ❑ Gas Lighter 0 Gas Log
❑ Heating Unit 0 Lam Sprinkler 0 Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
O Ventilation 0 Water Heater 0 Water Line 0 Wood/Pefiet Stove (must be EPA cer 6ed,,provide make, model and
manufacturer). • I .
Cormlete all applicable information on the application. incomplete applications will not be accepted.
Application # T 00a9l
Date
Job Site Address (mquired)
Value of Construction (labor, materials, profit* Ur
Property Owner Name Addre s
> ily/State zip. Phone
SA
Applicant Name Address
at),/State Zip Phone
Contractor Address
City/State Zip Phone
AL, Pj,
Contractor Oty of FL Collins Sales Tax #
Are you paying taxes hale or by report? JKHere 0 Report
<e =rownba^fr mpked by anMn=:±«s
Are you Paying with your trust account? O.Yes kff No
Js this a residenb�f or commercial Project? JK Residential ❑ Commercial
Tf residential, is it: . O Single Family Detached O mndo/townhome (single familyattached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is fi 0 Bank 0 Bar E3 Church ❑ Hotel/Motel CI Med;al'ofitce 13 Office 13 Retaf
Restaurant . 0 Other (erglain)
Is this building 50 years of age or more? . 0 Yes .T No Ifyes, ywmVna�dto mn&rtHLKaric vamen
If this. is for a demolition permit, what year was the building mrrsbuded?
Vprlontb 1975, yvL W71 Aeed an asbEWs azmMEl2f tnsuhgirl 0 V& 0 15 a) 7PAj a 6op,
Description of work
*If lawn sprimWer/hackgow preventer, must list licensed plumber. If first time Air, must list rioensed electrician.
Surbeontractors: List the aWanyn?W a air eRCoObahavue 9
Aedrioan minibar W-56:5MedrMmirat Roofer Other
I hereby adoiowledge that I haveread. this application and stata.that tare above infonretion is complete and correct I agora to
comply with all requirements contained herein and city ordinances and state laws regulating building construction, I know that a
perrnitls not'valld until It heal bees paid°arid'issued:
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