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HomeMy WebLinkAbout415 NOQUET CT - APPLICATIONS - 6/14/201306/12/2013 15:02 970-506-2730 ALPINE GARDENS PAGE 04/11 Planning, Development &Transportation 281 N. College Ave P.O. Box SM Fort Collins, OD SD524 Phone 970-416-2740 Fax 224-6134 .Otf ER -;THE -COUNTER -IPERM#'S .ONLY `This application is to be used to apply for the following Permits only (check all that apply). ❑ Air Conditioning Cl Demolition (interior non-structural) ❑ Electrical AReration (not service change) !a Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic l7 Ventilation 17 Water Heater ❑ Water Line p 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 # -5130 aol ae YOL Date U -114 -13 Job Site Address (iwajr dJ Value of ConslnocUon (labor, matzrials, profit) Property Owner Name Address Gty/Stake Zip phone Applicant Name Address city/state Zip Phone Contractor Address — I Gty/State Tip Phone Contractor City of Ft. Collins sales Tax # Are you paying taxes here or by report? "$,Here M Report 3$rcaAre you •paying with your tout account? ❑ Yes No ZZ7;'(oto, is this a residential orrommerdal project? K Residential ❑ Commercial . If residential, Is it l7 Single Farmly Detached C7 Condo/townhome (single fadfyattadred) O Duplex A Mull family (apartment) ❑ Garage if commercial, Is It: ❑ Bank 0 Bar ❑ Church ❑ Hotet/Moisd ❑ Medical offine ❑ ofllce 0 Retail 0 Restaurant ❑ Other (ehyiain) is this building 5o years of age or more? . ❑ Yes •T No Ifyes, you maned to arnbcY'HistpdCP2�rr�tion Jf this,is for a demolition permilk what year hiss the building acted? ,ifpdotrA? 5975, )vL M7/need an asbeshes assessment to subme nia4 ihls appAmon. Description of work *If lawn sprinlder/baddiow preventer, must list licensed plumber. if first-time Ate, must list 8censed electrician. Subcontractors: Us ftmmpanywmevrCNvofMCbIDnslhvM,>s 13edridarL PlrhmdeJa �'�Mechanl©�� Raoltr OBher I hereby adciowledge that I have read this application and state that the above Information Is complete and COMect I agree to comply with all requlremerds contained herein and city ordinances and slate laws regulubg. building meson, i know that a parmit is ndrvnUd Until It'hiM beadpaidagd'issued: ''"