HomeMy WebLinkAbout1439 FRONT NINE DR - APPLICATIONS - 8/7/2014To: Planning and Development & Transportat Page 3 of 9 2014-08-07 20:21:42 (GMT)
19706928189 From: David Perez
City of
fort Colons
Planning, Development:&
281 N. College Ave P:0. Bo
Fort C011ins,.00 80524
Phone 970416-2740 Fax:2
OVER -THE -COUNTER -PERMITS ONLI
This application isdo be used to applyfor the following permits only (check all that apply).
❑ Demolition (interior non-structural) ❑ Electrical Alteration (notspryice change) q:Gas Lighter
❑ Heating Unit ❑ Lawn Sprinkler n Mobile Home replacementRoofing ❑ Sewer Line ❑
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provi
manufacturer).
Complete all applicable information on the. application. Incomplete applications will not be
Application # 1405 Va
For oh%e use only
Date 8/7/2014
I Air Conditioning
❑ Gas Log
make, model and
L4
Job Site Address (required)
II
Value of Construction (labor, 1111ll
terials, profit)
1439 Front nine Drive Fort Collins CO 80525
7000
Property Owner Name Address
City/State Zip
Phone
Rrawand Mary 1439 Front nine DriveForl Collins CO 80525 9704827639
�
Applicant Name Address.
City/State Zip
Phone
Glenn Rennar 5489 Gulfstar Ct Windsor, CO 80528 9703917935
Contractor Address
City/State Zip
( Phone
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
Here ❑ Report
sales tay. number & required by all amtrdctors.
Are you paying with your trust account? [p
Yes ❑ No
_ 00049405
Is t)iis a residential or,commerclai project? Residential ❑:Commercial
If residential, is it: .XSingle Family Detached ❑ Condo/townhome (single family attached) ❑
❑ Multifamily (apartment) ❑ Garage.
If eommercial,:is it: ❑ Bank ❑ Bar ❑ Church ❑.Hotel/Motel ❑ Medical:office ❑ Office ❑ Re
❑ Restaurant ❑ Other (ex I - )
Is this building 50 years of age:ormore? ❑ Yes No If yes, you may.neEd to contactNisfoac P
If this is fora demolition permit; what year was the building constructed?
If prior to 1975, you will need an asbestos asse%sment to submit with this application.
Description of work
*!f dawn sprinlder/backflow prevenber, must, list licensed plumber. If first-time A/C, must list licensed
Subcontractors: List the company bame or CityI of Ft Collinsiiaense ,f
Electrician Plumber Mechanical Roofer'
I hereby acknowledge thatI have read this application and state that the above information is complete and
comply with'allrequirements contained herein and city ordinances and state laws regulating;huilding constru
Permit Is not valid until it has been paid and issued.
Applicant: %
Prirrt Flame: Glenn Rennar Mill ure_ JCS ram_ pate
t. I. agree to
I knowthat a.