HomeMy WebLinkAbout908 PINNACLE PL - APPLICATIONS - 10/21/2014Oct.21, 2014 1:46PM BDR
City of
orpt Cailins
No. 2489
Planning, Development th Treruportation
281 N. College Ave P.O. Box Sao
Fort Collins, CO 80524
Phone 970-416-2740 Pax 224-5134
P. 1 /2
This application IS tOVERbe used t,TNE4OU apply for the INTER PERMS ONLY
❑ Demolition (interior non-structural) ❑ Electrical AReration (not serving ce Change) O Gas Check all that a�ihtr❑p Gas Log Conditioning
❑ Heating Unit Q Lawn Sprinkler ❑ Mobile Home replacement NI Roofing ❑ Sewer Line ❑ Photo -voltaic
CI Ventilation 13 Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA Certified, provide make, model and
manufacturer).
Complete all applicable Information on the application. Incomplete applications will not be accepted.
Application #,,b I �JL 1( $
Foroflia+ useon/Y — Date
Job Site Address (Iwa#w) Value Of ConstmIctlon (labor, materials, profit
Property Owner Name Address
wState 7jp Phone
Applicant Name Address
�1►1 n. City/ Zip Phone
Contractor Address
;:L — _ ci_ _ /^ _ City/stete zip Phone
Contractor City of R. Collins Sales Tax #
Are You Paying taxes here or by report? ❑Here ❑Report
.sores trxsaoa°nacto x Are You paying with your trust account? ❑ Yes iS No
Is this a residential or commercial project? Residential ❑ Commercial
If residential, is it: ❑ Single family Detached O Condo/townhpme (single family attached
❑ Multifamily (apartment) p Garage ) ❑ Duplex
If commercial, is it: CI Bank ❑ Bar p church ❑ HoteVMotel D Medkal office ❑ office ❑ Retail
❑ Restaurant p Other (explain)
Is this twilling a yearsolitio of age or more? ❑Yes X No rfM Y& MY to �� y c �
If this 's for a demolition permit, what year was the Building constructed?
IfpW to 1975, Aw will need an asbestos anent m submit with 6* ajz�/kVw-
of work
*If lawn sPinlder/baddlow prevarrter, must list IloerB d plumber. If first_I A1q must list Ikensed ele can.
Subcontractorer LL* ffm rompanY Rsw aC ?Yoff? L 2ft hbmw
Electridan
P MeftnMal_ _. RaotW Other
m plby ac all
that I have read this application and state that the above Information Is complete and correct. I agree to
requiremenrs Contained herein and city ordinances and state laws regulating building construction. I knew that a
permit Is not valid until it has been paid and Issued. ,6—
Applicant: I
Print NaMeJnzSloru tt re
Data
P to