HomeMy WebLinkAbout808 E LAKE ST - APPLICATIONS - 5/29/2013FROM :NCR
FAX NO. :9702299983 May. 29 2012 11:26AM P1i3
Clay of Planning, Development & Transportation
F t Collins
Fort N. College Ave P.O. Box 580
�••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 CI Gas Log
Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line 0 Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer)_ '
Complete all appli
cable Information on the application. Incomplete applications will not be accepted,
Application # Date
For office use only
Is this a residential or mmerdal project? f TResidendal ❑ Commercial
If residential, is it: or
Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is It: ❑ Bank ❑ ear ❑ Church ❑ Hotel/Motel 13 Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (expl )
Is this building su years of age or more? ❑ Yes A No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this applicat/on.
Description of work
(.
*If lawn sprinkler/ba&flow preventer, must list licensed plumber. If Flrst-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft coNins license A
Electrician Plumber. Mechanical_._ Roofer
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 constructlon: I know that a
permit Is not valid until it has been paid and issued.
Applicant:
Print Nam
Date