HomeMy WebLinkAbout4107 SUNCREST DR - APPLICATIONS - 9/11/2014FCIt Y Of Planning, Development &Transportation
281 N. College Ave P.O. Box 580
_ _Ort Collins Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
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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) El Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicabblle� information on the application. Incomplete applications will
not be accepted.
Application # 0 1 Val Date
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
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Property Owner Name
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Address
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City/State
Zip Phone
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Applicant Name
Address
City/State
Zip Phone
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Contractor
Address
City/State
Zip Phone
Contractor City of Ft. Colli s Sa es Tax # i ,-y��
Sales tax numberis required by all contractors. Are you paying with your trust.account? PYes ❑ No
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Is this a residential or commercial project? 4 Residential ❑ Commercial
If residential, is it: .Single 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 XNo 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/backlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. 5A
Subcontractors: List the company name or City of fit Collins license # i
Electrician Plumber Mechanical Roofer 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. I
Applicant: \ j
Print Name:A) h
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