HomeMy WebLinkAbout4403 MONACO PL - APPLICATIONS - 7/31/2014This application is to be used to apply for the following permIte only (chock all that apply). ❑ Air Conditioning
❑ Demolition (inferior non-struetuml) ❑ Electrical Alteration (not service change) 0 Gas Lighter 0 Gas Log.
• Heating Unit ❑ Lawn Sprinkler O Mobile Home replacement "KRooflrig ❑ Sewer Line ❑ Photo=voftk;
Ventilation ❑ Water Hester O iNater Line Q Waod/Peliet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete an applicable information on the application. incomplete applications will not be accepted.
071
Application i_ , IA-0.¢$7'f' Hate d�T.1 '
Farofrica use only `
Job Site Address �requinsd)
Valueof Construction (tabor, materials, profit)
L'I1-�1o3 )�Accaco l
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Prop" Owner Name Address
City/State Zip
Phone
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Applicant Name Address
OtyJState Zip
phone q 7G -
A raGb% boo Tytc. at'i l,J- T��l� l F`"CC Ca $oS?zS
2.07-9240900
Contractor Address
ty/State Zip
Phone
Conti r City of Ft. Collins Sales Tax a
Are you paying taxes here or by report? 10 't$em 0 Report
serrsmrnumberrsreQvPadtyeamnr eca
Are you paying with your trust account? 'Yes
0 No,
Is this a residential or commercial pro)eW 15Rr'sidendal CI Commercial
If residential, is It: 0 Single Family Detached 0 Condo/townhome (single family attached) 0 Duplex
CJ Multifamily (apartment) 0 Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church 0 HoW/Motet 0 Medical office 0 Office ❑ Retall
❑ Restaurant ❑ Other (explain)
Is this building so years of age or more? O Yes ONO JFYes, yoAVrn0Y48 d to mntatth'fsltdon
If this is for a desnolttion permit, what year was thd-building eonstrLicted?-
Ifprrarto 197Y, You will need an aamslrxs assessment to submit mob drisappliOfion.
of work
'Elf lawn sprin1der/baddlow preventer, must list licensed plumber. If Rrs"me AX; must list lice-med eieRridan.
Subcontractors- Leffiec rnpanynameorcltyafRagmsiows&A
t7ettrldanPiumhar. MedrenlCal Roofer �` ISSq Other
i hereby a0mowledge that I have read this appilCatton and atate that the above inrormatlan is complete and correct. I agree to.
comply with till requirements contained herein end city ordinances and state laws regulating building construction. I know that a
permit is not valid until it has been paid and issued. '
t
Applicant: �etntn I ]call S Signature ` '�-DOW
Print Name —J