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HomeMy WebLinkAbout918 BOLTZ CT - APPLICATIONS - 4/13/2015F6aty, & Pllaansainor aa:velopment a Transp©rtation r"6r cowns 28;1, hi< College Ave P,0, "sue 38d Fort Collins, CC 80524 Phone 970.436-2740 Fax 224°6134 OVER- i7 HIE-COUN f3 ER !P'8ER9 OTsa QM = tV 12 This application is to i0® used 3o apply loythe't°®Slowing perrnits t rnl r-'hsesia Sig that R i Cl Air Conditioning Demolition (interior non-structural Electrical Pg to Q ileHAlteration (not serv�icyy change) Cl Gas lighter ❑Gas Log g Q Heating Unit ❑Lawn Spranl<I®r M E�®h'sie l�oni® replacement .�`�c3srling Q Sewer LIrzE Q Photo -voltaic ❑ Ventilation El Water l'lez3er n yyaYeY Line r� Wood/pellet Stove must be EPA certified, provide make, model and man<rfacrurer). Complete all Mulicable i:nlormaxl©r os; ,the appilc;ation. lncorn slot a aialsiications, evil€ nWL be accepted. Application # U50e32's Far office use only Data J012 Site Address- io.,,,f a'dl _ (labor, materials, profit) 2, 3oo.oa Properly Owner Name - - — — Address /State Rio Phone q,217 (te/S- A�w �. ri��. So,h 7`� S L . C A QiS"/a0 3 7-) - /1-:t (o Applicant Name Address — -- City/site 21p Phony; � Contractor eaC ., :address .. City/Sb3te Zip Phone .c t (oil>h Z arL�' P� Contractor City -r Ft Collins gales "ax {= 0 � .' 9; : �19 � f� i &?/e~star. mberis qurredbyalla�ntrctos. Are You paying imxes here or by report? Were © Report Are you paying with your trsist accot,int? es $,No i Is this a residential or commercial pro ect? - f �esldendal ® Commercial If residential, is it: A -Single Family Dewoche E2 Condo/townhotvte (;;angle family attached) E2 Duplex Mulbfamlly (apartment) Garage If commercial, is it: Bank gar �+ Churchd »otel/Motel l� Medical office office rC 1Q Restaurant o abr (explain) . etatl Is this buiidtng 50 yeae� c aq(a or more? L] yes r No di` es If this is for a demali�iorr r y , you stay,7ead to coniuctk//smHe vresenodor I Ifprfear to 1,975, you will need an9ashastos ris ear was a building constructed? _ �aMVnt a0 submit with Ibis Description�f wort � - - r� ac *If lawn sprinkler/backflow preventer, musL.iist licensed plumber, If first-time A/C, must: list licensed decatcian. alai l ss List the co,w,aany name or CIPI of Fi S°n111ns #wnse 0 i Eleeexlcian ?iumbw Mecitanl®I Roafcr i. / L-9 Other i x hereby acimawledge that I have read this appiiCa-taon and state that the abave information is roMPIete and con•ect. I agree to amply with all requirements contained herein and City ordinances and state laws regulating building Construction. I know that prrn esit is more valid until it has n paid aind as�ae d. f APPiicarat; .-� Prig$ Maine: J olnci cov<vadA Signature