HomeMy WebLinkAbout618 MEADOW RUN DR - APPLICATIONS - 9/4/2014Planning, Development & Transportation
QW10f 281 N. College Ave P.O. Box 580
f Fort Collins, Co 90524
phone 970-416-2740 Fax 22+6134
OVER.THE.COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). E3 Air Conditioning
p Demolition (interior non-structural) O Electrical Alteration (not service change) O •Gas Lighter ❑ Gas Log
• Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Plioofing ❑ Sewer Line 0 Photo -voltaic
0 Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pallet 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 1 4 0 11
fbronrne rise only
Data q A l l
Job Iffiffe Address (n;q~)
IgaZZ value of construction (labor, materlals, proet)
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Property OwneMame Address
City/State Zip phone
A nt Name Addresss^s
City/State ZIP Phone
"l
con Address
City/State ZIP Phone
Contractor City of FL Collins Sales Tax #
Are you paying taxes here or by report? E3 Here ❑ Report
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Are you paying with your trust account? E3 Yes ❑No
Is this a residential or oomTprilal pr4ect? @.Rdidentlal A Commercial
If residential, is R: EkSTngle Family Detached E3 Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) O Garage
If commercial, is it: 1❑ Bank 13 Bar C3 Church 0 Hotel/Motel 13 Medical office M Office ❑ Retail
13 Restaurant O Other (explain)
Is this building 50 years of age or more? 13Yes p No Dyes, you mayneed to amntaetHis/r7licRrawnation
If this is for a demolition permit, what year was the building constructed?
Ifp Or to 1975, )au will need an asbestae asmssmenrtowbmit with this application.
work
*If lawn sprinkier/baddiow preventer, must list ileatwd plumber. If firsHme A/C, must list licensed electrician.
Subcontracbmm Lathe companyname or Qty ofPt Collins l/ce= #
Plumber Mani®! R00AV02-LunOther
I hereby admowledge that I have read this application and state that the above Information is complebe and correct. I agree to
amply with all requirements contained herein and city ordinances and slate laws regulating building construction. I kuuow that a
permit is not valid until it has been paid and Issued.
Applicant;
print�
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