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HomeMy WebLinkAbout913 ASHFORD LN - APPLICATIONS - 2/3/2014City of Planning, Development & Transportation �r{*�' 281 N. College Ave P.O. Box 580 ` CottiA r� 1s Fort Colllns, CO 80524 . Phone 970-416-2740' Fax 224-6134 OVER-THE-COUNTERPERMITS ONLY This application is to be used to apply for, the following permits only (check all that apply). ❑ Air Conditioning © Derilolition (interior non-structural) ❑ Electrical Alteration (not service change) 0 Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑, Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater p Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete applications wilt not be accepted. Application # m t?O6�>-7 Date Z%3 Far ofte use only Job Site Address (required) Property Applicant Name Contractor Value of Construction (labor, materials, profit) . s� City/State Zip Phone?-;EP• City/State ZIP Phone Oty%State ZiP Phone Contractor City of'Ft:Collins Sales Tax # Are yoU paying taxes here or by report? Q Here ❑ Report sales tax number Isregulredby,0conixidws. Are you paying with your trust account? 0 Yes I] No Address Address' Address Is this a residential or commercial project? residential ❑ commercial If residential, is it: ningte Family Detached ❑ Condo/townhome (single family attached) 11 Duplex ❑ Multifamily (apartment) ❑ Garage ' If commercial, Is it: ❑'Bank ❑ Bar ❑ Church 13 Hotel/Motel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? ❑ Yes' XNo If yes, you may need to contact HislamePreservalron If this Is for a demolition permit, what year was'the building constructed?: If prior to 1975, you wit/ need an asbestos assessment• to submit with this application. Description of work *If lawn sprinkler/backnow preventer, must list Ilcensed plumber. 'if, first-time A/C, must list licensed electrician. L/sl'the Company name or City offf Copins license. Electrician Plumber Mechanical. ffi. a(29, aocifi!r ether I hereby acknowledge that T 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. Applicant: Print Name ,9n ,;A �. �{it'Yrfi/(_Q}�j��'�Q�gd�.2� , �" Date