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HomeMy WebLinkAbout4318 WINTERSTONE DR - APPLICATIONS - 10/27/2014NOU-01-2014 09:45 From: �© Plannin, Collins J� y� 281 N. C Fort Coils Phone 97 OVER-THE-COUNTER PEN This Vilification is to be used to apply for the foltowin O Demolition (interior non-structural) ❑ El g permite only, d Pleating Unit ❑ Lawn Sprinkler C3 Mobile ectrical Alteration (not se G Ventilatipn p Water Heater ❑ Water Une p yY replacement manufacturer), ood/Pellet Stove (must Co"fete all %Wicable information on the application, Incomplete ap Application # d Form sae only Date 30b Site Address (rer�dcy) .- Pl0pertyr Owner Name Address Applicant Name Address Contractor Uc I��Lt l g Address i Contradm City of Ft. Collins Sales Tax P smwsax11 'l* dbradcvnbacv= Value of $ 1-2, City/State To:19702246134 Pa9e:3�5 i 00VOIGIPrnent & Traer>p.rtation age Ave P,O. aox 580 , CO 80524 416-Z740 Fax 224-6134 MITS ONLY 1ck all that apply). Ci Air Conditioning j 9e) 0 Gas Ughter ❑ Gas Log O Sewer Line O photovoltaic EPA SPA certified, provide make, model and!; rations will not be accepted, -__ !D /2�-/ 19 (labor, materials, profit) Coll:�� Zip <VO-gJ6 Phone(,, Zip Phone City/$tetE es-'Zi p %�O�.L Ph*n �2a Are You paYM6 takes or by report? M Here r3 Report AM You paying wi!"I your trust account? ❑ Yes ck No Is this a residential or 00"Jmerdal project? Residential O Commercial If residential, is k: n9� Family Detached ❑ Condo/townhome (single C3 Multifamily (apartment) (] Garage If commemw, Is it: D Bank IO Bar p Church O HoteVi iotel O Medical 0 Restaurant ❑ Other (explain) $ lhIS bulft 50 Years of age or more? O Yes O No If yes; you may IN IItthis is for a demaimm permit, what year was ft building Constructed? Oda m 1974 Wu will need an asbestos a went to suhmlt w/dh psis yypp,/b Description of work *If lawn sprinkler/baddiow presenter, must list lic�sed p mt�er. If first-time A/[, -----b�acwm List the companyname orCity oftt Col/lns #lte/W # I hereby edamwledge that I have read tthis appiication and state that the above 11 wil h all reQwrernents contained herein and dty ordinances and state laws permit Is not valid until it has been paid and issued. APWkan Print Hansa:_ Signature attached) , ❑ Duplex C] Office ❑ Retail to con&Wt HftWc AesenobiDn list licensed Is complete and correct. I agree tp - building construction, lI know that a Date . x.