HomeMy WebLinkAbout431 W TROUTMAN PKWY - APPLICATIONS - 10/3/2014Planning, Development & Transportation
281 N. College Ave P.O. Box 580
nS Fort Collins, CO 80524
�. Phone 970-416-2740 Fax 224-6134
I 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 s rvi change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑Lawn Sprinkler ❑ Mobile Home replacemi fing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑Water Heater ❑ Water Line ❑ Wood/Pellet Stov must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # �,�(40Q4s91 Date I Dr'
ForlofFce use only
Job Site Address
(required)
V lue of Construction (labor, materials, prof
CU
S
Property Owner Name
l� Address
ity/State Zip
Phone 920
Applicant Name (V
� "�t(lC'E Address
City/State Zip
Phone
O �
—
Contractor —
Address
City/State Zip
Phone
Vr
-
�' V15E
Lk
Contractor City of Ft.
Collins Sales Tax #
Are you paying taxes here or by report? ❑ Report
Sales tax number isrequredbya//contraUors.
e4.4
I
Are you paying with your trust account?
❑ YesYl�l0
>`
Is this a residential ! c mmercial project? Residential ❑Commercial
If residential, is it: Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
PRestaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes No lfyes you may need to contact Historic Preservation
If this is for a demolition permit, what year was t e building constructed?
if prior to 1975, you will need an asbestos assessment to submit with this application.
Description
*If lawn *inkler/bacl,
Subcontractors: List
I hereby acknowledg
comply with all requi
permit is not valid
preventer, must list licensed plumber
first-time A/C, must list licensed electrician.
company name or City of Ft Collins license #
Plumber Mechanical Roofer Other
I have read this application and state that the above information is complete and correct. I agree to
is contained herein and city ordinances and, state laws regulating building construction. 1 know that a
it has been paid and issued.
Applicant:
Print Name:_ f1 \ kp_ Signature Date