HomeMy WebLinkAbout901 CONSTITUTION AVE - APPLICATIONS - 5/15/2015City of Planning, Development & Transportation
281 N. College Ave P.O. Box 580
F6rt Coth s 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 XRoofing ❑ 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 #�QiP
For office use only
Date /5 - 1�
Job Site Address (required)CV3.£&
Value of Construction (labor, materials, profit)
901 Constitution Ave. Ft. Collins,CO. 80521
Q . 5l'o
Property Owner Name Address
City/State Zip
Phone
Rams Village Apts. LLC 399 Perry St. Ste. 203
Castle Rock/CO. 80104
970-493-2801
Applicant Name Address
City/State Zip
Phone
Jonah Lovendahl 1713 E. Lincoln Ave. #B-3
Fort Collins 80524
970-493-2801
Contractor Address
COCity/State Zip
Phone
ACC Roofing, Inc. 1713 E. Lincoln Ave. #B-3
Fort Collins CO. 80524
970-493-2801
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? X Here ❑ Report
Sales tax number is required by all contractors. Are you paying with your trust account?
❑ Yes XNo
42178
Is this a residential or commercial 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 ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes XNo Ifyes, you mayneed 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 A to%o,� -tVs_ !!2 _k���"� ro� 2 ✓ur` (. +V-0of
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*If lawn sprinklerlbackfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician,
Subcontractors: List the company name or City of Ft Collins license #
Electrician Plumber Mechanical Roofer R1819 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 Name: Sonia Gilbert Signature
Date /