HomeMy WebLinkAbout600 GRIFFIN PL - APPLICATIONS - 8/21/2018FCity of Planning, Development, & Transportation Services
ort Collins 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
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not servjce change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement 10 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 # k) I -S n ill _H cO Date
For ofte use only
]ob Site Address (required) Value of Construction (labor, materials, profit)
00 6 l,-Ce- i F Cndif7j $2500
Property Owner Name Address City/State Zip Phone
61hma Saber (Qoo 6viF; PI C L)OII;h- Go osa 970- yq)-y y
Applicant Name Address City/State Zip Phone
se'e'
Contractor Address City/State Zip Phone
On Target Roofing 5210 Coral Burst Cir, Loveland CO 80538 970-619-8902
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? Here ❑ Ranort
sareytax number s,e47Ldjedbya#ccntrackm Are you paying with your trust account? ❑ Yes L9 No
Is this a residential or mryrherdal project? U4sidential ❑ Commercial
If residential, is it: Mingle 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 50 years of age or more? ❑ Yes ❑ No If yes, you may need tv cuntaet Historic Preservatlon
If this is for a demolition permit, what year was the building constructed?
Description of work -e 00 - 21 squares - intall Malarkey Vista
*If lawn spdnkler/badtflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List Me company name or Gty of Ft Collins llcwse # (� b 0 ✓I
Bectrician Plumber Mechanical Roofer m �d 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.
�"" !A Q
Perin Name: M i C V�u e( r' l l �f Signaturee - Date U I 1
Rwisim a 2AM17