HomeMy WebLinkAbout1133 OAKMONT CT - APPLICATIONS - 4/24/2015FROM :NCR
FAX NO. :9702299983 Apr. 24 2015 09:30AM P2/2
City of
ort 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).AAir Conditioning
❑ Demolition (interior non-structural) M Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line Q Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable Informationon the application. Incomplete applications will not be accepted.
Application # F315 0 Rqq I Date
For office use only
Sob Site Address (required)
Value of construction (labor, materials, profit)
Owner Name
Address
City/State Zip
Phone
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Applicant Name
Address
Clty/State Zip
Phone
Contractor
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Address
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Contractor City of Ft, Collins Sales Tax #
Are you paying taxes here or by report? (Mere
❑Report
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Are you paying with your trust account? >iCYes
❑ No
Is this a residential or 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 CI Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes Z' No If Yes, you may need to contact Historic preservation
If this Is for a demolition permit, what year was the building constructed?
I prior to 1973; you will need an asbestos assessment In submit w/th this application.
Description of work
-it lawn spnnaler/backnow preventer, must list licensed plumber, If first-time A/C, must list licensed electrician.
Subcontractors: Opst the company name or City of Ft Collins licensee
Nectricla waa 04C' 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. I know that a
permit Is not valid until it has been paid and issued.
Applicant:
Print Nam
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