HomeMy WebLinkAbout908 LAPORTE AVE - APPLICATIONS - 6/15/2012Jun 1512 03:28p Air Masters LLC 9705322006 p.1
Fort of
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
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 (chock 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 0 Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information.onn the application. Incomplete applications will not be accepted.
Application # A0 7I8 1 Date l� 1 S-J2 69- 33
Far office use only
Job Site Address &Walred)
Value of Construction oabor, materials, profit)
c2 OCR
Property Owner Name Address
City/State Zip
Phone
Applicant Name Address
City/State Zip
Phone
Contractor Address
/!,JizS( K-S L- LP G 7
City/State Zip .
�- L - J C S055�
Phone C
S52 ;-7tei`
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Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? X Here
-❑ Report
Salestaxnwnbers1 uiredbyat)ronrraaws.
Are you paying with your trust account? ❑ Yes
- *No
3 igiv5
Is this a residential or commercial project? Residential ❑ Commercial
If residential, is it: AJ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hctel/motel ❑ Medical office ❑ office ❑ Retail
❑ Restaurant ❑ Other (expl ' )
Is this building 50 years of age or more? ❑ Yes No If yes, you may need to CV17tact Historic Preservahon
If this is for a demolition permit, what year was the building constructed?
Ifpnor to 1975, you will need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinkler/badkflow preventer, must list licensed plumber. If first-time A/C, must Iist licensed electrician.
Subcontractors: L&Me company name orGtyofRCollin5Ikense 0 !v�/
Electrician Plumber Medianical f I r Roofa 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: C ,
Print Name: - i Signature allG Date