HomeMy WebLinkAbout601 JUSTICE DR - APPLICATIONS - 1/26/2012Jan 26 12 09:19a Air Masters LLC
9705322006 p.1
Fort Collins
OVER-'
This application is to be used to apply for the fol
❑ Demolition (interior non-structural) ❑ Electrical A
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home
❑ Ventilation Water Heater ❑ Water Line ❑ V1
manufacturer).
Complete all applicable information
, on the appli
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Application # d /—l)lJ `0 1
For offlre use only
Planning, Development & Transportation
261 N. College Ave P.O. Box 560
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
`ER PERMITS ONLY
permits only (check all that apply). ❑ Air Conditioning
i (not service change) ❑ Gas Lighter ❑ Gas Log
ment ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
let Stove (must be EPA certified, provide make, model and
Incomplete applications will not be accepted.
DateZ/'L
Job Site Address (required)
Value of Con uction (labor, materials, profit)
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Properly Owner me Address
•; City/State Zip Phone
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Applicant Name Address
City/State Zip Phone
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Contractor Address
Gty/State Zip Phone
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Contractor City of Ft. Collins Sales Tax #
ere ❑ Report
Are you paying taxes here or by report? %es;
Sates t number isregpired by a# contaiws
Are you payingwith your trust account? ❑ No
Is this a residential or commercial project? )S.Resi tial; ❑ Commercial
If residential, is it: Single Family Detached ❑ ndo/townhome (single family attached) ❑ Duplex
_11❑ Multifamily (apartment) ❑ 3ara6e
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ otel/Motel ❑ Medical office ❑ Office ❑ Retail
O Restaurant ❑ Other (exp in)
Is this building 50 years of age or more? ❑ Yes ' 1 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 assessmen to submit with this appircation.
Description of work
*If lawn sprinkler/backflow preventer, must list licensed lumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or Cty of RCAInsAcense
Electrician Plumber Meclianical Roofer Other
I hereby acknowledge that I have read this application
comply with all requirements contained herein and city
permit is not valid until it has been paid and issu
Applicant:
Print Nam
that the above information is complete and correct. I agree to
s and state laws regulating building construction. I know that a
Date i 'AL
1, 2z•
74,