HomeMy WebLinkAbout606 TYLER ST - APPLICATIONS - 8/1/201803/09/2015 10:57 9705872178
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CiA°�DijI11S Planning, Development; & Transportation Services
Community Development & Neighborhood Services
281 North College Avenue
Fort Collins. CO 80524 Main: 970.416,2740 Fax: 970.224.6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
C] Demolition (Interior nort-structural) ❑ Electrical Alteration (no2fou'st
change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacemenfing ❑ Sewer Line ❑ Photo -voltaic
❑ Ver latlon ❑ Water Heater ❑ Water Line ❑ WoodlPellet S be EPA certified, provide make, model and
manufacturer).
Complete all applicable ipf • rm 'on�he ap Ication. Incomplete applleatic sT
ll not be accepted.
10 Application #_� ��UC/ Date f
For use only
Job Site Address (rPqu`red) �1 Value of Construction door, materials, profit)
rroperty ,jr Na a
Address
City/Sta e__ ZiP
phone q %
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Addr
Ci . /S Zip
phone (/i
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Contrall ti U
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Address
.. " 'C'ityr/State P
Phone
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Contractor City of R. Collins�,m
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Are you payng taxes here or by report? Herea
Are you paying with your trust accoul A3 I
Report
❑ No
Is this a residential mercal project? ❑ Residential l7 Commercial
If residential, is it:LJZSkgle Family Detached ❑ Condo/townhome (single family attached). 13 Duplex
❑ Mulftmily (apartment) ❑ Garage
If oominercial, is It: ❑ Bank Q Bar ❑ Church ❑ Hotel/Motel • ❑ Medical Office ' ❑ Office ❑ Retall
13 Restaurant ClOther (explain)•
Is this building 50 years of age or more? U Yes O No If yes, you may need to c0ntactH1SjWcpfesi lion
If this is for a demo)i�.permit, what year was the building construll
*If lawn
of work Ir"% C
must list licensed plumber. If first-timial -
Subcontractors: List ft Company name or aty of Co/pns!/aertse #
list licensed electrician.
9ecrridan . 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
mmpiy with all requirements contained herein and City ordinanos•and state laws regulating building construction. I know that a
Permit 12 not valid until it has been paid and issued.
Applicant: �r
Print Name:
5ignature,_. � Date � � U •
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