HomeMy WebLinkAbout4112 SUNCREST DR - APPLICATIONS - 7/14/2014FROM :kessler IFAX NO. : Jul.14 2014 09:0BAM P1
MINK111, 01310111 111 L TORNA10111
�} 281 N. College Ave P.O. Box 580
rt 011inS Fort Collins, Co 80524
Phone 970-416-2740 Fax 22+6134
OVER-THE-COUNTER PERMffS ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
E3 Demolition (interior non-structural) 17 Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit 0 Lawn Sprinkler 0 Mobile Home replacement XRoofing 0 Sewer Line 0 Photo -voltaic
❑ Ventilation 0 Water Heater 0 Water Line 13 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 # BV3'4D
Far o/Tce use on/y /
Job Site Address (required)
4112.
Value of Construicdon-pabor, materials, profit)
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Property Owner Name Address
City/State Zip 97I� phone
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Applicant Name Address
City/state rp Phone
Contractor Address
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city/state Zip J Phone
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Contractor City of Ft. Collins Sales.Tax # !r!!54rodP$ sales favmonber isrequ Wbyaffmnoada Are you paying with your trust account? Wyss ci No
Is this a residential or commercial project? Pnkesldentlal 0 Commerdel
If residential, Is It: 1] Single Family Detached p COndo/townhome (single family attached) ' D Duplex
0 Multifamily (apartment) Cl Garage
If commercial, Is it: ❑ Bank O ear ❑ Church 0 Hotel/Motel E3 Medical office 0 Office CI Retall
0 Restaurant ❑ Other (explain)
Is this buliding 50 years of age or more? 0 Yes ONO Ifyes, yvo maynead to cpntactH/sh7dc prewivaum
if this is for a demolition permit, what year was the building constructed?
Ifpwr to 1975, ytw W11 need an asbestos anent to submit wid) UYs appJUMm.
Of
lawn sprinider/bacldlow prewnter, must list Uoense6 plumber. atf first-tl(ne A/C, must list licensed electrician.
Subcontractors: Ustibecampanyname orOtyoff?Co0wftmW.0
FlecftidarL Plumber MedwrftW snorer 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 hat been paid and issued. -
PrintApplicant: !ee>ew mess e�
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