HomeMy WebLinkAbout609 JUNIPER LN - APPLICATIONS - 6/3/2015FROM :NCA
FAX NO. :97022999e3 Jun. 03 2015 04:03PM P1/2
City of
Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 470-416.2740 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)./2Alr Conditioning
D emolitlon (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
O 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.
Date
Application # B I 51D ,, o 3. '
Fnr nlrjrB "Se OnIY
Is this a residential orImsiultifamily
merclal project? (�Residentlal ❑Commercial
If residential, Is it:ingle Family Detached Q Condo/townhome (single family attached) ❑Duplex
(apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ liar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office 11 Retail
❑ Restaurant O Other (explain)
Is this building 50 years of age or more? O Yes j�No ff yes, ynu may need to contact Hisharlc Preservation
If this is for a demolition permit, what year was th building constructed?
If prior 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: L/st the company name or City of Collins license 0
Electridan_„_,_ Plumber Mechanical,. 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 ail 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 Nam
Date (4*' `' _-