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HomeMy WebLinkAbout1809 STOVER ST - APPLICATIONS - 3/28/2012Mar 28 12 08:00a Wasters Roofing Q j Crty of Flirt CoWns 9705688448 planning, Development &Transportatiion 281 N. College Ave P.O. Box 5W Fort Collins, Co 80524 Phone 970-416-2740 Fax 224-6134 PA OVER-THE-COUNTER PERMITS ONLY permits only (check all that �r Conditioning This application is to be used to apply for g ❑ Demolition (interior non-structural) ❑ Eleddoal Alteration (not service change) ❑ Gas Lighter ❑Gas Log ❑ Heating Unit O Lawn Sprinkler ❑ Mobile Home replacement C] Roofing ❑ Sewer Line ❑ omake! aiiodel and ❑ VentHation ❑ Water Beater 17 Water Line ❑ WoodfPellet Stove (must be EPA certified, provide manufacturer). Complete all applicable Information on the application. Application #, E3 b W O WY Forolice use only Incomplete applications will not be accepted. Date Value of Construction (labor, materials, profit) lob Site Address (n�qurn?d) � � O. 00 �� � Address CitYlState Z'P Phone Property Owner g!M S Applkant lam State / Address .. T c 1_, �_li ZIP Phone 0 IQ Contractor Address Cawstate zip Phone 1SS 5 Lt `r City of Ft. Collins es # Are you paying taxes here or by report? ❑ Here 9 RePort Contractor dv Are you paying with your trust account? Yes ❑Pin sales lax number Isrequ+red by afl Is this a residential or commercial project? A Residential ❑ Commercial If residential, is it: Aft Single Family Detached El COOo//townhome (single family attached) ❑ Duplex © Multifamily (apartment)Garage If commercial, is it: ❑ Bank P Bar ❑ church 0 HotellMotel 17 Medical office ❑ Office ❑ Retail 0 Restaurant ❑ Other (explain) Is this building 59 years of age or more? ❑ Yes No n°Y�. you need � � PteServabOrl � If this is for a demolition permit; what year was the building constructed? Ifprfor t o i975, You wr l need B17 asbestos assessr►ent to -submit this applkalYon. Description of work *if lawn sprinkler/bad6iow preventer, must list licensed plumber. If first-time A/C, must 16t&hnsed elect iClan. Subcantractom: ClstMecnmparrynamecrOWofFtCaoinsIKense* 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 consbvdion. I know that a permit is not valid until it has been paid and Issued. P�lp��hn R/'S tl Signatu����� gate 3 ,Zg-�/Z