HomeMy WebLinkAbout412 THRASHER ST - APPLICATIONS - 8/10/201408/10/2014 22:22 FAX
0001
Fort Collins
Planning, De"apmoftt L Wanopertatken
761 N, Collate Ara P.O. aux 300
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-TH&COUNTER PERMITS ONLY
This application Is to be used to apply for the following permits only (check all that apply). CI Air Conditioning
Q Demolition (interior non-atructurai) O Electrical Alteration (not service change) ❑ Gas Lighter O Gas Log
O Hesting Unit 0 Lawn Sprinkler O Mobile Home repiacanmut 12 Ruufng O Sewer Line O Photo -voltaic
a ventilation O Watar rdantar r1 Watar I in& n VdArAIPAIIAt Stria (mi rat hn FPA rAdified, provide make. model and
manufacturer). lDq
Complete all applicable hNomwftn on the application, Incomplete apolieatone will not be accepted.
Application * lnSW Date t5nw14
For dyke rests dins
Ws Ma Addnanx (noWdr od)
Value of Co118b'uctlon (labor. profit)
412 Thrasher St.. Fort Collins, CO 80526
C9 6
g
property Owner Name Address
/State 27p
or
Phone
Robert Flynn 412 Thrasher St.
Fort Collins, CO 80628
970-21 MO16
AntrlirAnt Name Address
CItv/5tate Zip
Phone
Craig Schultz 3864 Ash Ave
Loveland, CO 80538
970-288-3014
Contractor Address
City/State Zlp
Phone
Schultz Roofing & Repairs, LLC
SAME AS ABOVE
Contractor City of R. Collins Sales Tax #
Are you paying takes here or by report?
m Here O Report
saw 53 � � �
Are you paying MW yuur truat du.uui it?
M Yea C3 NW
Is this a residential or commercial project? ® Residential CI Commercial
If residential, Is It: ® Single Family Detached O Condo/townhome (single family attached) Cl Duplex
0 MuMftmly (aporbnrnt) O Carago
If commercial, Is it: CI Bank CI Bar CI Church Gl HoW/Motel CI Medical office CI Office C) Retail
O Restaurant CI Other (explain)
Is this building so year's are" or more f V Yes to No it ye3* Wu may need w wnrocr Hawn mew v vvn
If this Is for a de- to permlk what year was the building constructed?
If pdar to 1973r yGu w/I/ need an 83MO s assessment to SUbMit WM MIS ap/r&VbbA
OeacrlpLW ur wurk istanuvtr 1 Iaren of aciphall alrhaelea, inatail 00# felt. loan water ahield an p vea, and drip adaea.
*Ir lawn sprialer/baddlow preverftr, must list licensed Plumber. if first-time A/C, must list licensed electrician.
Sabcontiadors: LN On emppaw name or Otv of R C alft 6imm 0
number Rooky " Other
I hereby adawwledge that I have read this application and state that the above Infgmadon Is complete and correct I agree to
comply with all rogidrempr a rrvkahvrl hmpin arvl rlly nrdW swim arrl ateda lawn rerpi"na hulhllno enrd2ructIon_ I know time a
pannR is not valid until It has been paid and Issued. -
n �,
print
Craig Schultz �;
Pr1rli Hams: Signature � � �t'1 ' " 0'�'�`'—Deft 6/10/14