HomeMy WebLinkAbout3230 MONARCH CT - APPLICATIONS - 7/25/2014City,of Planning, Development & Transportation
281 N. College Ave P.O. Box 580
�F6r` Collins Fort Collins, CO 80524
`. Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMITS ONLY �>8'ao
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ 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 # SI A-044" . Date
For office use only /
lob Site Addns (requlred)
Value of Construction (labor, materials, profit)
oe
Property Owner Name Address
City/State Zip
Phone
Applicant Name Address
City/State Zip
Phone
Jo-Tettv 17112,ellA zy
4'
,
Contracto Address
city/State Zip
Phone
Z3
-9 99
Contractor Crty of Ft. Collins es Tax #
Are you paying taxes here or by report? 50ere
❑ Report
Sa/estaxnumberLsmquAmdbyallcnbad=
Are you paying with your trust account? ❑ Yes
V-,No
Is this a residential or co_Mmerdal project? . ,.Residential ❑ Commercial
If residential, is it: WSingle 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 contactHbinric Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you w111 need an asbestos assessment to submit with this appl/cadon.
Description of
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or 19ty ofR Collins license ,#
Sedridan Plumber Meftnicai 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 brow that a
permit Is not valid until It has been paid and issued.
Applicant:
Print Nam
pate