HomeMy WebLinkAbout6445 GARRISON CT - APPLICATIONS - 7/2/2014JUL/02/2014/WED 12:04 PM DELTA MECHANICAL -AZ
FAX No,480-898-0005
P. 002
Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
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). JZF.Qir Conditioning
❑ Demolition (interior non-structunal) ❑ Electrical Alteration (not service change) ❑ Gas Light ❑ Gas Log
Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ hoofing ❑ 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 #'h I + Date f 1 +
For ofte use only
Job Site Address (required) /� Value of Constrruc�tion _(labor, materials, profit)
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Property Owner Name Address /► _Crty/State
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Applicant ame Address Gty/State
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ZIP $ %' p
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Contractor U Address City/Stage
Zip gIV4 W. o
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Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by reportZere A R rt
.sale. Wxnumberisrequired byall conirachvs Are you paying with your trust account- ❑ Yes No
Is this a residential or mercial project? Residential ❑ Commercial
If residential, is it: ASirngie Family Deta ed 0 Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If Commercial, Is It: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant 13, Other (explain
Is this building 50 years of age or more? 17 Yes o If yes, you mayneed to aontactHutonc Preservation
If this is for a demolition permit, what year was the building constructed?
Ifprfor to 1975 you will needan asbestos assessment to submitWthh this appli4oblon.
Description of work
*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name orCty of Collins lkense .0
Electrician' 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: L
Print Slgnature _ Date a I
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