HomeMy WebLinkAbout4137 SNOW RIDGE CIR - APPLICATIONS - 5/22/20151
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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ 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 # � l � �� 5 Date �2 J
ForotAce um only
Job Site Address (repaired)
Value of Constriction (labor, materials, profit)
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Property Owner Name Address
City/State Tip
Phone
Applicant Name Address
City/State Zip
Phone
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Contractor Address
City/State zip.
Phone
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Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
grtere ❑ Report
sa�esraara„m6rr s,epa;,�vyaUmrtr��ios
Are you paying with your trust account?
VYes ❑ No
Is this a residential or commercial project? gResidentiai ❑ Commercial
If residential, is it: fOSingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
0 Multifamily (apartment) ❑ Garage
If commercial, -is it: ❑ Bank ❑ Bar ❑Church ❑ Hotel/Motel ❑ Medical office ❑ office ❑ Retail
❑ Restaurant ❑ Other (explain9)
Is this building 50 years of age or more? ❑ Yes ITNo Ifyes, you mayneed to contact Historic Preserrd6on
If this is for a demolition permit, what year was the building constructed?
Ifpnorto 1975, you IN//Reed an asbestos as emnenth7 submit w/tli thisapprcafton.
Description of work fear nCF L sfa �y !'� {�' l%� erJ�,c: , i rip .fagot
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*If lawn sprinider/baddiow preventer, must fist licensed plumber. If first-time A/C, must list licensed electrician.
SubaartradDYW list the camparryname orGtycfFtCa///nsrcer:zse # lsS zrn f4
Medridan Plumber Mkhaniral Roofer RltptSS Other
I hereby admowledge that I have read this application and state that the above iirfon, ation is complete and correct I agree tv
comply with all requirements curtained 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.
Piri:; nt: Zt QQ. � {- _ signature gate
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