HomeMy WebLinkAbout4130 SUNCREST DR - APPLICATIONS - 8/6/2014Planning, Development & Transportation
City Of 281 N. College Ave P.O. Box 580
Fort Collins Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
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 0,**Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ 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 #
For office use only
Date
Job Site Address (required)
Value of Construction (labor, materials, profit)
30
LP-
2-2.13
Property Owner Name
Address
City/State
Zip
Phone
c I.rO
C
.1u
LL .
S Z
— 991-
Applicant Name
Address
City/State
Zip
Phone
7)21 A in
S
-323-ZZ33
Contractor
Address
City/State n
Zip
Phone
01,6Ld ,rrn�.wr,(
7� S S►1a
o Sr'" te.9b
3 bib-3977
Contractor City of Ft. Collins Sales Tax #
Sales tax numberis required by all contractors
EA
Are you paying with your trust account? ❑ Yes E NO
Is this a residential or commercial project? residential ❑ Commercial
If residential, is it: Ingle 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/baclflow 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 RooferS[.L 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 Nam
Signature
Date k -I