HomeMy WebLinkAbout6315 TREESTEAD RD - APPLICATIONS - 5/27/2015City of
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
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 #T:::)I !�—!D 3 '3 - Date S 20 1 LS
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
(�0 3 l S it ec S l 19cj
IV. 1 Z, door
Property Owner Name
Address City/State Zip
Phone
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la3(5 % L-e-S+coA '1j F&co64-5 `O 905ze
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Applicant Name
Address City/State Zip
Phone
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ISIZ RL"4111y6on FrrCo1l«5 CC 905_Z5
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Contractor
Address City/State Zip
Phone
L'oaecr Cocn
1912 Rer-+r,�94-an S E F6Co(1,,,5 CO
3a7-Vif-0,,9
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? j�Here ❑ Report
Saiestax number isrequiredbyall contractors. Are you paying with your trust account?
❑ Yes >I�No
Is this a residential or commercial project? Apesidential ❑ 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 5o years of age or more? ❑ Yes XNo If yes, you mayneedto contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifprior to 1975, you will need an asbestos assessment to submit with this application.
Description of work Re -Roof- bin +6 Re - Rco
k)&-, Lotf"irna,-fe- ,$k,^afcSl y 3 SQ 7 S`10ry
*If lawn sprinkler/backflow 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 # Carl
Electrician Plumber Mechanical Roofer Can54 "cfrnrbther
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:
"Tbriaf cLaR
V
I,0->6efd Signature
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Print Name:
Date