HomeMy WebLinkAbout807 BONITA AVE - APPLICATIONS - 4/1/2014Fort Collins
Planning, Development & Tral
281 N. College Ave P.O. Box 58
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply).,
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑
❑ Ventilation 0 Water Heater O Water Line ❑ Wood/Pellet Stove (must be EPA certified, provi
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be
Application # -?)I y hq I Date Z///
For otrice use only
it Conditioning
Gas Log
make, model and
Job Site Address (required)
Value of Construction (labor, materials,
profit)
'K oN I T
33145
Property Owner Name Address
City/State Zip
Phone
C 2 5 U !i N sc7 Boo 1 rAAvF T Cow s (,fl �a5.)-ir, q
Applicant Name Address
City/State Zip
Phone
e uITS a39 C). 'SP
L.ovR �DS
e�
3
Contractor Address
City/State Zip
Phone
-R P77I.ST- Lov449 F0537
70-
3_qcn
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑
1
Here ❑ Report
Sales tax n m4eris�7uiredbyallcontractors.
14 4
Are you paying with your trust account?
i
Yes ❑ No
Is this a residential or commercial project? WResidential ❑ Commercial
If residential, is it: XSingle Family Detached ❑ Condo/townhome (single family attached) ❑
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ RE
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic f
If this is for a demolition permit, what year was the building constructed?
If piior to 1975, you will need an asbestos assessment to submit with this application.
plex
Description of work L 5 A)
I
I
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/c, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electrician e- " 5 Plumber Mechanical l -�> / 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 construction. I know that a
permit is not valid until it has been paid and issued.
Applicant:
Print Namel tt P.(S l36-1-777S Signature
Date