HomeMy WebLinkAbout4107 TORRINGTON CT - APPLICATIONS - 11/5/201411/05/2014 11:16 3038349799 ARMOR PAGE 02/02
City of
Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
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). 13 Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler O Mobile Home replacement ty htcofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line IDWood/Pellet Sto must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # P1 Ll / lF C) Date s /Y
For office use only
Job Site Address (raqulmd)
Value of Construction (labor, materials, profit)
o
'»
LK' o 47a
Property Owner Name
Address
City/State Zip
Phone
/07'r r'
� 4J.(-,,O// 815a5
Applicant Name
Address
City/State Zip
Phone
Contractor
Address
City/state Zip
Phone
4T� alb
G C�19alykils
ea
Contractor City of Ft. Collins Sales TaLi
Are you paying taxes here or by report?
❑ Here ❑ Report
Sales tax numberisr u/na7by all contractors
Are you paying with your trust account?
❑ Yes V,0
Is this a residential or�a ercial project? ❑ Residential ❑ Commercial
If residential, is it: I�CSi}gle Family Detached ❑Condo/townhome (single family attached) ❑Duplex
�j M`ulildfamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (expl I
Is this building 50 years of age or more? El Yes
o If yes, you mayneed to contacrHIseoHc Preservation
If this is for a demolition permit, what year was th building constructed?
Ifpnor to 1975, you will need an asbestos assessment to submit with this application,
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If rkt-time A/C, must list
Subcontractors: List the rompanynameorCity ofFeCollins Acense fi
Electrician Plumber Mechanical Roofer
I hereby acknowledge that I have read this application and state that the above
comply with all requirements contained herein and city ordinances and state I
permit Is not valid until It has been paid and issued.
Applicant: �%
print Name: ZP� 17 & rl geJ Signature
electrician.
Other
is complete and correct. I agree to
building construction. I know that a
4P 3.5,9