HomeMy WebLinkAbout4342 ARCADA CT - APPLICATIONS - 8/5/2014This application Is to be uses' to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non-structural) Q Electrical Alteration (not service change) ❑ Gas Lighter O Gas Lag
❑ i-teaiing Unit 0 Lawn Sprinkler ❑ Mobile Home replacement Roaring ❑ Sewer tine a Photo-voltale
El Ventilation Q Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. inoompleto applications will not bo accepted.
Application # '(��Q-OS1(� Date OS : tiS. 2014.
Foraff/W use ONY
Sob Site Address (regulmd)
Value of Construction (labor, mauls, profit)
Li-5 L-I 2 A- c
C) o 0 • °; y
Proerty Owner Name Address
Ctty/State Zip
Phone
j;J
Applicant Name Address
aty/State ZIP
Phone 4 -A9 -
1
Ti-AIO 1ZcQ PTA C'a US'a e3
2.¢7-ej6,0 a
Contractgf Address
ty/State ZIP
i
Phone
Contt%Wr City of Ft. Collins Sales Tax
Are you paying taxes here or by report. > ,
f3 Report
.,eks tax„wnlacr,ts,em.*eceyau=nrra&ms
Are you paying with your trust account? i$'Yes
0 No
Is this a residential or eommerdai project? II$ Residential 12 Commercial
if residential, is it: I,ld Single Femily Detached 13 Condo/townhome WNle family attached) M Dupiex
0 Multifamily (apartment) ❑ Garage
If commercial, is it- ❑ Bank ❑ Bar .LI Church ❑ Hatel/Motel ❑ Medical oliiae ❑ Office ❑ Retail
0 Restaurant ❑ other (explain)
Is this buliding So years of age or more? M Yes ❑ No IT yesr yrw may need to CaoRtat HLgVrtt AVSSr 0=0
If this is far a demolition permit, what year was thii-bullding consvuLhi14-
JrArforM 197$ You wAY Reed an asbastos assemment to submit with this applacabrOm
Description of work -e-• t� a ' ` if O �:5
}onr it LY'G
°If lawn spr9nWer/bac[cFlaw preveriber, must list licensed plumber. If first-time A/C; must list licensed eiectridan.
SubcontractOnC. iktCre=mv mrYmmmcr0(y°fRC-4hhshbmwA
8edrtdan Plumber Madrenimi Hooter �- 1959 Other
I hereby acknowledge that I hava read this application and state that the above Information is complete and cOrreacr, I agree to
comply with all requhernants contained herein and city ordirianaes pnd state laws regulating building eonstrudian. I know that a'
permit is not valid until it has been paid and Issued.
Appileants JJ�� ��tnv► t S Signatvta '• �.,. �' - Date .�.-