HomeMy WebLinkAbout6107 PHEASANT CT - APPLICATIONS - 2/11/2016 (2)Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
This application is to be used to apply for the folloviing permits only (check ail that apply). ❑ Air Conditioning
Den;oiition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
-leating Unit ❑ Lawn Sprinider ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
Cl Ventilation [I Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, modal and
iT,ar li.ifacturer).
Complete at•i applicable information on -the application. Incomplete applications will not be accepted.
Application � t / (d �)�� I Date
For office use only
Sob Site Address (•ra7uii2d) �y Value of Construction (labor, materials, profit)
(�l�I1Pas(.rrf- lL.
� D �'03015 ,5�604 — —
Pi onrty Owner Name Address City/State Zip Phone
__FlFlENS 190- Of9a
Applicant Name- Address City/State Zip Phone
J �� e���� � � t,a f a :�.� � � ° �- 9'ill�`:.� �., �,➢ . � �.. :�.;� i3t� �� ��' � l� - �� ��1— Ll ��ll
Contractor,-) Address City/State Zip Phone
4)Jr-1 p;rt/a tJ,C. ! 5° 1'N.'L. ��. ;�� 60 f�fJ��/ G���
Contractor City of Ft. Collins Sales Tax ## Are you paying taxes here or by report? ❑ Here Report
•; > tag number isrequ%redbyall contractors Are you paying with your trust account? 'Pes ❑ No
Is this a residential or commercial project? Residential El Commercial
If residential, is it: `j Single Family Detac ed ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If6mmercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is! this building So years of age or more? ❑ Yes ❑ No Ifyes, you mayneedto contact Historic Preservation
If this is for a denacifltion permit, what year was the building constructed? _—
r; ,rvior to 1975, yOu avil/n ed an asbestos assessment to submit with this application.
Description of r
ork
ff lawn sprinkler/backflow preventer-, must list licensed plumber. If first-time A/C, must list licensed electrician.
subcontractors: List the company naive or City of Ft Collins license m
LICcl.ridan _ _ _ Plumber Mechanical Roofer Other
f h;oreby 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
pormit is not valid until it has been paid and issued.
u
Applicant:�
Print Name:>k- .J�,l �' -7 R9 r Ju�D Signature