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HomeMy WebLinkAbout901 DRIFTWOOD DR - APPLICATIONS - 8/14/2015FROM :kessler FAX NO. : Aug.14 2015 07:57RM P1 C rto& 281 N.6College 010p111 o. a I1t8rispDrrnoon ` �� Zt31 N. College Ave P.O. Box 58l] 1000- Fort Collins, CO 80524 Phone 97G 41&274o Fax 22"134 OVERooTHE40UNTER FERI S ONLY This application to to be used to apply fbr the following Perrrt[ta only (ehociC all that © Demapply), O Atr Conditionirrg olitlon (interior non-structural) d pedrical Aitsralion (not service change) o Gas Lighter ❑ agg LDS D Heating Unit 0 Lon Sprinkler © Mobile tiome rWiscamerit jKRoo ft p Seaver Line D Phokwo>ft ❑ nukkature [] Water Heater ❑ Water Line D Wood/Pallet 8tcva (must be EPA certified, Provide make, model and manufacturer). Complete Sit applicable information on the apPilcatlon. Incomplete applkatlone will not be accepted. APPlicadon #_'- Sblc" Poi a9Rce rrsa only _^..` Job Site Address (mqulmd) PrOPertY owner Name . Address yr Applicant Name Address vaiue of Conarucuon (labor, matelfnis proiRJ CRY/Stift ZIP Phone FTC �®Szs C97o 23, CRY/State ZIP Phone Contractor Addrm QtY/Stale appJ Contftr CW of FL Collins Sales Tax # �rrsSormm�deraroyrd ederam Are you P3ft wfth your trust aaoouW JWYes Phone Is this a nesIdential or commenYal Project? )WRegd�al 13 Caring v residewal, is 0: P11111gle Famly Detached 0 Condo/townirotrre (_qng* famly ataach 13 rage D DuP!®c If colmerdal, Is it © Hank 0 Bar O church D Ho D Restaurant 0 other (evlaln)0 Mddleat oHke 0 Ofiice O Retail Is this building so yeas of Ne or more? D Yes ,lt4No lfya� y�gyr� H,o� If this is for a demolition tsermiq whet year was the building mast udee �°A'�m 1975, yrau wl/lrrsedan ast�ms rto swMm/twltll �� . Description of WriAldw/baddlow prevenUer, must SubcotrtradArs: [Lst the If fir a NQ must iiot lioenged eEtcbddan. anyneworQyofFtGillis # [] No Ekmrdan p»nber RWw Odrer -. • ..o.a.7 «+ wmtmga U=,L rravz neari tws appltcedon and sift that the above irMonrraCon Iscam comply with all requirements mtained herein and d4r ordlnanaet and scree laws Plate and extect. I agree to permit Is no# vuiht until it Iran been paid and issued. g con*udlon. I katow tl "a y�ka �..Iy�,+�m $