HomeMy WebLinkAbout449 DENNISON AVE - APPLICATIONS - 9/9/2014"Yjw=
2.81 N. Collage '6'va P'0P_C'% 530
Fort Collin
F10--rc QAhns
hone 017041&1"70 F.ax =11-6114
OVERMTHE-COUNTER PERMITS ON22LY
This application is tobaused lo.applyfor tha, tollowing perWta only,(chook all that apply), ri AirCondi*)06y
cj-.Demolition (interior non-structural) 0 Electrical Alteration (not servi change) DGas Ughter C! Gas Log
0,Heating. Unit n1awn,Sprinkler 0 Mobile Horne replacementVRoofing 13Sewer Line OPhoto-voltaic
OVentliation 13'Water-Heater Oftter'Llne 0, Wood/Paltat Stove (must be EPA. carlified.. provide make, -model and
manufacturer)., n
Complete,all-applicable information on- I Incomplet
�n J), - �'W 'Ication. 6 appliclions fill not be accepted.
Applicad Da
Job Site Address, (*ulhad) Value of ConsttuCtllon (labor, inttedals,. piroft)
Property-'QWner Name Address
City/State Zip
Phone
Applicant Name Address
City/State Zip
Phone
. C -nt"ra, r Wc # Address
City/stato- Zip
Phone
I
Contractor City of FL Collins SalTax #
Are you paying taxes here or by report?
PlIere 13 Report
Wes tax number is required by all con&actors
Are you paying with I your trust account!
&-1ei; .1i No
ls'thisA.resid,O-,nodipr.corDKe-rci6I project? G�Residenbal MCommerdial
If, residential, is It., C 3 Angle Family Detached 0 Condo/townhome (single family attached) 13.• Duplex
13 Multifamily (apartment) ' biSirage*
If commerclal� is it: 0 Bank Cl Bar d Church Cl Hotel/Motel 13 Medical office .0 OMce O'ketail
CI Restaurant 13 Other (explal
Is .this building 0.years of age or more? C3 Yes No if yes, you may need to contact Histodc Preservation
If this Is fora'
permit, what year was the building .constructed?
&;vribi to 1975, you W/l/ need an asbestas assessment to submIt with this application.
Descdptfon of
lawn s list licensed Plumber. If first-time A/C, must 1 11 electrician.
prinkler/bkkilow preventer, must list licensed
Subcontractorst Ustffiecompanvname or-Glyofft Collin license #
Electriclpn Plumber Mechanical Roofer Other
..that1have read this application and state that,theiibove information is complete and correct. I agr� to
ements contained herein and city, ordinances and state. laws,regulaitin.9 building
construction 1knoW.,thata
until it has been pWd and issued.