HomeMy WebLinkAbout936 SAILORS REEF - APPLICATIONS - 4/16/2014MAR/26/2014/WED 05:57 PM Delta Mechanical Inc
FAX No,866-692-5275
P. 029
City of
,,E6rt Collins
Planning, Development &Transportation
281 N. College Ave PA, Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
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) ❑ Electrical Alteration (not service change) O Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation VWater 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 #�; I N co l a 01 Date ti /16/ / 41 _
For office use only
Job Site Address (mqulred)
Value of Construction (labor, materials, profit)
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Property Owner Name
Address
Clty/State Zip Phone
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licant.N a
Address
City/State Zip Phone
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Address City/state Zip Phone
bonE. bose.l11-4) 0. Av 35A %b-b1A•5a-i3
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N6611
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes.here or by report? . Here ❑ Report
salestaarnu eer/Srnqulredtryaucatraaor�
Are -you paying with your trust account? LAKes ❑ No
Is this a residential or commercial project? A Residential ❑ Commercial
If residential, is It: ❑ Single Family Detached Q Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) 0 Garage
If commercial, is it: 171 Bank CI Bar ❑ Church ❑ Hotel/Motel El Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes o Ifyes, you may need to contact Historic preservat/on
If this is for a demolition permit, what year was tht building constructed?
If pnor to 1975, you will need an asbestos assessment to submit wRb th/s applIodon.
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber, If first-time A/C, must list licensed electrician.
Subcontractors; List the Company name of Q'ty of Ft Collins license #
Electrician Plumber Mechanical Roofer Other
I hereby acknowledge that I have read this appiicadon 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 R has been paid and issued, r,
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Applicant:l.Li
Print Name.