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HomeMy WebLinkAbout6315 TREESTEAD RD - APPLICATIONS - 11/4/2014 (3)NOY � t Planning, Development & Transportation Cite ®# t L01=i 281 N. College Ave P.O. Box 580 Fort ®Wns — — — Fort Collins, CO 824 'may Phone 970-41616-274740 Fax 2246134 GIVER -THE -COUNTER PERMRTS ONLY This application is to be used to apply for the following permits only (check all that apply). NIAir Conditioning ❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log 14 Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation 0 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 # b )y ( 2-24S Date For office use only li/.4li4 Sob Site Address (required) lr h l 5 S I e �a _• ` (1 Value of Construction (labor, materials, profit) Cs-I'�c-i L. (' �J 0 5 5CP Property Owner Name Address City/State Zip 2,ot 2to Phone `? ° 0'_ L�) I'7 9W r'Lc ti i Applicant Name Address Zip Phone 7 O C.i,�%�� �v n eb�Y °J7 L1nl t; tCity/State A1,4, i. O —LLCi ui , J Q)�`i31 Ocb -I l uv Contractor 1 Address City/State Zip '3bs 3 l Phone 11'lo J)'Jei1S (��Pi,_L'in�. ff tr••77 \ r'IV'''v Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? © Here ❑ Report Sales tax number is required by all contractors. Are you paying with your trust account? ID Yes ❑ No 53 Llo Is this a residential or commercial project? j@ Residential ❑ Commercial If residential, is it: P Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, Is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 5o years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation If this is for a demolition permit, what year was the building constructed? If prior to 1975, you will need an asbestos assessment to submit with this application. Description of work *If lawn sprinkler/backnow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the company name or City of Ft COMBS license # Electrician Plumber Mechanical Roofer Other I hereby acknowledge that 1 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 (Name: Date 1 1 /-1 / 1 `t