HomeMy WebLinkAbout331 WHEDBEE ST - APPLICATIONS - 5/8/2014Planning, Development & Transportation
City, of 281 N. College Ave P.O. Box 580
FOI ` Collins Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-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) PQ 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 Line ❑ 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 # ee) Lf d '2� 4—
For office use only
Date ��S l % 01 �l
Job Site Address (required)
Value of Construction (labor, materials, profit)
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Property Owner Name
Address City/State Zip
Phone
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Applicant Name
Address City/State Zip
Phone
Contractor
Address City/State Zip
Phone
Contractor City of Ft. Collins Sales Tax #
Sales tax number is required by all contractors. Are you paying with your trust account? ❑ Yes No
Is this a residential or commercial project? 19 Residential ❑ 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 yebrwas the building constructed? o'
If prior to 1975, you will need an asbestos assessment to submit with this application.
ption of work
'he %or /yew
*If lawn sprinkler/backnow preventer, musty licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electriciari 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:
Print Name: M lohue l AP0-44e-
Date S `6 Zo 1 L