HomeMy WebLinkAbout4142 HARBOR WALK DR - APPLICATIONS - 10/21/201410/21/2014 09:24 9703539774 INDEPEDENT ROOFING I PAGE 01
CityofPlanning, Development &'Transportation
281 N. F■ • othns Fort Collins,, CO 80524 O. Box 580
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). 0 Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement G Roofing ❑ Sewer Line 0 Photo -voltaic
❑ Ventilation I7 Water Heater ❑ Water Line 0 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 #� Date 10-21-2014
For ofte use only
.lob Site Address (required)
Value of Construction (labor, materials, prolit)
4142 Harbor Walk Dr.
$24,000.00
60 sqs.
2 sto
Property Owner Name Address
City/State
Zip
Phone
Arnie Knoll Same
Ft. Collins
80525
970-21
Applicant Name Address
City/State
Zip
Phone
r vv�i
Contractor Address City/State Zip Phone
vl V-
Is this a residential or commercial project? 14 Residential ❑ Commercial
If residential, is it: CR Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Hank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office O Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? i] Yes IR No If yes, Mu may peed too I vnmctN/stctk Preservat/on
If this is for a demolition permit, what year was the building constructed?
-Ifprier to 1975, you wi// need an a$bWl!Vs assessment to Subm/t Wlth this applftbn.
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*If lawn sprinkler/backflow preventer, must list licensed plumber. IF first-time A/c, must list licensed electrician.
Subcontractyrs: UstifiecompanynameOrCYofRCol/lnsIkense9
Elecrripan__ Plumber
Mechanical. itovfer --R--224^ Other
I hereby acknowledge that 1 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.
Applicant;
Point Name: Tim Kra er Signature rt4w Krasner Date 10/21 /2014