HomeMy WebLinkAbout900 SMITH ST - APPLICATIONS - 3/7/2012(j 0 Planning, Development & Transportation
FliCity, Of 010P k ,�, q L( 281 N. College Ave P.O. Box 580
rt Collins �Y �k �1, ,�(CA Fort Collins, CO 80524
�..- •Vm_ Phone 970-416-2740 Fax 224-6134
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OVER-THE-COUNTER PERMITS ONLY
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 applicjaabbl(e information on the application. Incomplete applications will not be accept e\ '
Application # V I � 1 ��V ?? Date 03 07-2012
For office use only IZ)U fQ- \-
lob Site Address (required)
Value of Construction (labor, materials, profit)
900 Smith St., Fort Collins, CO 80524
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Property Owner Name Address
City/State Zip Phone
Barbara & Kenneth Wilson 900 Smith St
Fort Collins/CO 80524
Applicant Name Address
City/State Zip Phone
429 S Howes St. Fort Collins/CO 80521 970-472-8100
Contractor Address
City/State Zip Phone
HighCraft Builders 429 S Howes St. Fort Collins/CO 80521 970-472-8100
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ® Here ❑ Report
Sales tax number isrequIredbyall contractors.
Are you paying with your trust account? ❑ Yes ® No
39751
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: ® Single 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 contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
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 construction. I know that a
permit is not valid until it has been paid and issued.
Applicant: /
Print Name:
Date g IZ