HomeMy WebLinkAbout221 CLEOPATRA ST - APPLICATIONS - 2/11/2015FEB-i1-2015(WEO) 18:15 P.001/001
CityOf Planning, Development & Transportation
F6r+ 281 N. College Ave P.O. Box 580
` Collins Fort Collins, CO $0524
Phone 970-416-2740 Fax 224.6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (Check all that apply). A'ICDnadWAring
Demolition (Interior non-structural) Electrical Alteration (not service change) Gas Lighter Gas Log
Heating Unit Lawn Sprinkler Mobile Home replacement Proofing Sewer Line Photo- I
Ventilation Water Heater Water Line WaodlPellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable Information an tho application. Incomplete applications will not be accepted.Cj5.1$
Application # B(5C)Ogm � _ Date h F`5 201
Forof/rte M only
Is this a residential or
If residential, Is It:
Commcrelal
nhome (Single family attached) puplex
multimmny [a—partment) Garage
If commercial, Is It: Bank Bar Church Hotel/Motel Medical artice Office Retail
Pestaurant Other (explain)
Is this building 5o years of age or more?. Yes IV�o 'fy4 ynu My need to cnntactHIZonc Uon
If this Is for a demolition permit, what year was the budding constructed?
!(prior to .197F,, you will need an asbe5= assrrsment to subnut with this applleapon,
of work
*If lawn sprinkler/backfiow preventer, must list llmnsed plumber, tF tlrst-dme A/C, must list licensed electrician.
Subcontractors: last Ure comp�nyn.)me arC/ry ofFt Collinslicrarso
EltcMelan,— -- ` PlumbC., Mechanical. Roarer
. Other_. .
t 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 as Permit l5 not valid until it has been paid and issued.
�/l-Ern.t' In.Zv 0, va-a5'k+�+-El T-c p l.&(-e
Applicant:
Print Nome. f CL� g
_ SI n3tu���' ,, Date�