HomeMy WebLinkAbout6400 BUCHANAN ST - APPLICATIONS - 9/13/2011city of, a
For-'M. of,
Plranning,1)eyelopment eL Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMITS 0,NKY
'his application is to be used to apply for the following permits only (check all that apply}. ❑ Air Conditioning
0 Demolition (interior non-structural) Ci Electrical Alteration (not service change) ❑ Gas Lighter 0 Gas Log
Heating Unit 0 Lawn Sprinkler Ea Mobile Home replacement Roofing 0 Sewer Line ❑ Photo -voltaic
0 Ventilation 0 Water Heater 0 Water Line 0 Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicabl information on the application. incomplete applications will not be accepted..
Ll./application # � -__ Date
For ace use only
.fob Site address (required) Value of Construction (labor, materials, profit) .
Is this -a residential or commercial project? i eResldential 1. ❑ Commercial
If residential, IS it: 0 single Family Detached ❑ CondoJtownhome (single family attached) Q Duplex
Multifamily (apartment) Garage'
If commercial, is It: 0 Bank CI Bar ;:. m Church 13 Hotel/Motel 0 Medical office. 0 Office 13 Retail
0 Restaurant ❑ Other (explain)
Is this building So years of age or more? 0 Yes 0 No If yes, you may need to contact Hfstorlc Preservation
If this is for a demolition permit; What -year was the building constructed?
:if pnor to 1975, you will need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plum4er. If first-time A/C,
Subcontractors: List the coFnpanyname or Qy of Ft Collins license #
ac
list licensed electrician.
1
ElecMdan 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 construction. I know that a
permit.is not valid until it has been paid and issued.
Applicant." r ID ,,v11i