HomeMy WebLinkAbout6445 GARRISON CT - APPLICATIONS - 7/2/2014 (2)JUL/02/2014/WED 12:04 PM DELTA MECHANICAL -AZ
FAX N0,480-898-0005
P. 002,
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). ❑ it Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) 0 Gas Light Gas Log
Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement El Roofing ❑ Sewer Line ❑ Photo -voltaic
Ventilation ❑ Water Heater ❑ Water Line ❑ Weod/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 # �??J Q,�4?� - Date. ` f I +
For OMW use only
Job Site Address (required) . Value of Construction (labor, materials, profit)
Property Owner Name Address City/State
Zip P i ne
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Applicant ame Address City/State
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Zip
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Contractor UAddress' City/State
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Zip g, o
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Contractor City of Ft Collins Safes Tax # Are you paying taxes here or by report? ere .,0�, Wort
swesrarnumaerisrepuiredayauconftacrws Are with trust aowun ❑ Yes
you paying your
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Is this a residential o meraal project? Residential ❑ Commercial
If residential, Is it: /Siingle Family Deta ed ❑Condo/Oownhome (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? O Yeso If yes, you may need to contact Historic Prest°rvatlon
If this is for a demolition permit, what year was Ifie building constructed?
Ifpnor to 1975, you will need an asbestos ammwnent to submit with this app/katfon.
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Lis_rthecampanynameoratyofFtCollinsikenw*
Electrician �d`r G. Plumber McOanicei Roofer Other
I hereby admowledge 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 bullding construction. I know that a
permit is not valid until it has been paid and Issued.
Applicant:
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