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HomeMy WebLinkAbout913 CHEYENNE DR - APPLICATIONS - 7/11/201307/12/2013 13:33 9704612547 Of. ATLAS PAGE 01/01 Planningr !Development & Transportation 281 N. College Ave P.O. f3ox 580 Fort Collins, CO 80524 Phone 970-416-2740 Fax 229-6134 OVER-THEmCOUNTER PERMITS ONLY This application is to he used to apply for the following permits only (check all that apply). ❑ Air Conditioning ❑ Demolition (interior non-structuraQ ❑ Electrical Alteration (not change) ❑Gas I,Ighter ❑Gas Lag b Heatihg Unit ❑ Lawn Sprinkler CI Mobile Home replacement �ng ❑ Sewer line ❑ Photo -voltaic ❑ Ventilation 0 Water Heater ❑ Water Line Cl Woodtpellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable Information on the application. Application # 3J PsoMy Incomplete applications will not'be accepted. Date 1 1 1 -- Sob Site Address (reguirgd) Value of construction (labor, materials, profit) �r Properly Owner Name Ce c Address City/State Zip phone ra�o Lc �, 190 E-4=11Ina -- �aQ-'�� �S` -1 / �/ Applicant Name � Address .• city/state ZIP Phone Contrador - - Address CI-154 r4ln City/State ziMick's !tone L A Contrac#ar City of Ft Collins Tax # '-I Gstaxrwrnherfsr dGyalicnrmacmrs Are You paying taxes here or by neport't ❑ Aere ❑Report Are You Paying with your bust account? crf YA ❑ No IS this a residential or commercial project? �Idential ❑ Commercial If residential, is it: p Single Fairly Detached O Condo/tvwnhome (singre family attadted) q Duplex 0 Mulftrrfdy (apartrnent) CJ Garage If commercial, is It: ❑flank ❑ aar p Church ❑ HoteVWtel p Medical office ❑Office ❑ Retail 17 Restaurant © Other (explain) Is this (wilding 50 years of age or more? f7 Yes d No Il}oes, yoamayneed to contaCtHi3cPreszeruab'On If this is.for a demolition permit, what Year was the building constructed? IfPior 6.1974 you wr!/ need an asf amessmentto submit w/tlr drisapp/icpbon of work *If lawn Sprintder/baWuw preventer, must list licensed plumber. If tirst time Atq runt list licensed electrician. Sub conftcb= L& Me tarnWnyname arOW ofFtCv07nsllb MW # Be<tridan P� _. me&anW Roarer oftr I hereby admowledge that I have read this appNcation aril state that the above information is complete and Coned. F agree to Corrurly with all reguirement5 contained herein and dry Ordinances and state WW regulating building CpnstrUc ion. I knew that a . permit Is riot valid until it hats borer paid and lased, MAR,f �= /