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HomeMy WebLinkAbout1320 LORY ST - APPLICATIONS - 7/9/2013Of Planning, Development & Transportation rtY 281 N. College Ave RO. Box 580 1 *,• F,6rt Collins Fort Collins, CO 80524 Phone 970-416-2740 Fax 224-6134 OVEN -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 ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water tine ❑ 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 For office use only Date Sob Site Address (required) Value of Construction (labor, materials, profit) 1320 i r Chili/?-' 8052h % - /10r Property Owner Name Address City/State Zip Phone L- y AW Acqrre� / 32a Tory .5 -F-F Co ll i,43 pp S 29 Applicant Name Address City/State zip Phone b:--cc 96* Accnet So(ar Contractor Address City/State Zip Phone R© Sol Q /' 113 / -4 &5c SAer da 0 e0 /14 72,o-51.�1326 Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? 116FIere ❑ Report sales oxnumber isrequired byaUmnbactors Are you paying with your trust account? ❑ Yes ❑ No Is this a residential or commercial project? IrResidential ❑ Commercial If residential, Is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, Is It: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? ❑ Yes ❑ 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 appllcatlon. Description of work fC004- y Yl Errs / I Me'u ,Ls; p -Flu r /-,)AVC GOM 'S *If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list iicensed electrician. Subcontractors: List the company name or City of Ft Collins license # Electrician Plumber Mechanical Roofer / 3 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 construction. I know that a permit is not valid until it has been paid and issued. Cal / c7 7, J(0&'�Jr 1Z -Dr ;�xy Lehi Applicant: �} � � ��� Print Name: �A'OCAVt S Signature l�:!���rit� L Date 4 1 l /l41:W'd�0 66 E1-60-LO