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HomeMy WebLinkAbout3237 SILVERTHORNE DR - APPLICATIONS - 6/26/2012Planning, Development & Transportation city of 281 N. College Ave P.O. Box 580 Fort Collins Fort Collins, CO 80524 /-^ Phone 970-416-2740 Fax f24.6� COVER -THE -COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check all that apply). CI Air Conditioning ❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) Ll Gas Lighter 0 Gas Log ❑ Heating Unit 0 Lawn Sprinkler ❑ Mobile Home replacement CI Roofing Q Sewer Lino ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater 13 Water Line Q Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplote applications will not be accepted. LA — Application # 8I�29cz Date � I Il L- r�arW% arse only Job site Address (nsgrened) Value of Construction (labor, materials, profit) Property owner Name Address City/State Zip Phone ! Gam, —` / " �JV2 Applicant Name Address City/State Zip Phone L Co ACC50��' I55oti Contractor Address City/State Zip Phone Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here Report .Wotax num&-ar" tercdryoff =nVadmm �-s Gc Are you paying with your trust account?'I Yes ❑ No Is this a residential or commercial project? ❑ Residential ❑ Commercial If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) Q Duplex l❑ Multifamily (apartment) ❑ Garage If commercial, is it: 11 Bank 0 Bar © Church CI Hotel/Motel 0 Medical office 0 Office Q Retail 0 Restaurant la Other (explain) Is this building ad years of age or more? ❑ Yes O No D yMrounWneedfoaarbci'Hb&wkPxese-*Wfidn If this is for a demolition permit, what year was the building constructed? Ir rkrtr1975, yartrvNnaedanamxswsasFemp ntto-QOY i`lvMfbs4Wf0Xm. Description of work f2ei�QJO_4G *If lawn sprinkler/backilow preventer�must lilicensed plumber. If nrst-time A/C, must list licensed electrician. Subcontractors: LLstdremvrtoaWrarrreor-Oryoff Cla9lnslkensL-4 Electdcien Plumber _ MechanlcelH1-9-0-T Roofer Other I hereby acknowledge that I have read this application and state that the above Inrormatfon Is complete and correCt. I agree to comply with all requirements contained herein and dty 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 Pate mm-