HomeMy WebLinkAbout508 VILLANOVA CT - APPLICATIONS - 7/21/2015JUL-21-2015 10:39AM FROM -
T-086 P.001/001 F-315
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
O Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter O 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.
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Application Date
For Or= use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
0525
5.1551
Property Owner Name Address
City/ tate Zip
Phone (970)
Ern f e
55
u8e-2378
Applicant Name Address
City/State Zip
Phone
Ft. Collins Heating and A/C
Contractor Address
City/State Zip
Phone
Contractor City of Pt. Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here
❑ Report
sarestaxnumberismquiredbyellcvnbacrors
Are you paying with your trust account? ❑ Yes
❑ No
Is this a residential or commercial project? XResidentiai ❑ Commercial•
If residential, is it: )KSingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment)' ❑ Garage
If commercial, is it: 13 Bank ❑ Bar ❑ Church ❑ Hotel/Motel 13 Medical office ❑ Office ❑ Retail
❑ Restaurant 13 Other (explain)
Is this building 50 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?
ff ptior to 1975, you will need an asbestos assessment to submit with this application.
Description of work
*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 1/cense p
electridan_ Plumber Mechanical. H 1309 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.
Print Name: Angela Morrow
Print Nam®; g Signature
Date 21 /15