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HomeMy WebLinkAbout4918 SAWHILL DR - APPLICATIONS - 10/31/2014NOV/03/2014/MON 02:08 PM DELTA MECHANICAL -AZ FAX No,480-898-0005 P. 002/003 p. City of Planning, Development & Transportation V 281 N. College Ave P.O. Box 580 r �t Collins For` Collins, CO 80524 Phone 970-416-2740 Fax 224-6134 OVER-THE-COUNTER PERMITS ONLY 40 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 service change) ❑ Gas Lighter ❑ Gas Log 0 Heating UnitP Lawn Sprinkler ❑ Mobile Home replacement 17 Roofing ❑ Sewer Line ❑ Photo -voltaic C7 Ventilation 1W Water Heater ❑ Water Line ❑ 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 #. �I � 11�q-� • Date fbr office use only Sob Site Address (r muired) Value of Construction (labor, materials, profit) qatit • A0 00045 Property Owner Name Address City/State Zip Phone An>n dkf2a G .1 - q-9510 Applicant Name J Address City/State Zip Phone oe- now lout/ vffee Z i Contractor j Address t 1 City/State Zip Phone &OCOA4 br �a i l G I1 rid '66 11Z 4�A Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? Ef Here ❑ Report �iesraxn;� eri dbyallw4rractom Are you paying with your trust account? R(Yes ❑ No Is this a residential or commercial project? ?f Residential ID Commercial If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) © Garage If commercial, is it: ❑ Bank ❑ Bar d Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail O Restaurant ❑ Other (explaf Is this building 50 years of age or more? ❑ Yes OrNo If yes, you may need to contactHistanc: Preservation If this is fora demolition permit, what year was the building constructed? IrPHer tP 1975, you will need an asbestos assessment to submit with this application. Description of work *rf lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors; List the company name or City of ft Co//ins license # EleCWclart. Plumber Mechanical Roofer Other I 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. t know that a permit is not valid until it has been paid and issued. Applicant: Print Name:_ zJ' 1 e Signature , ze Date