HomeMy WebLinkAbout931 FOSSIL CREEK PKWY - APPLICATIONS - 3/7/2016MAR-07-2016 08:49AM FROM-
9704849364 T-527 P.001/001 F-487
Cty of
art Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line Q. 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 # s"1 Date
For offlee use only
lob Site Address (required)
Value of Construction (labor, materials, profit)
9-31 ossi c k
831gZ l
Property Owner Name dress
City/ to Zip
Phone
61 a31
r s co
222-
Applicant Name Address
City/State Zip
Phone
Fort Collins Heafing and Aar 208 Commercr,
Dr- 44 Port. Collins. CO 96S24
(970)
305-3479
Contractor Address
City/State Zip
Phone
Fort Collins Heating and Air 208 Commerce Dr. #4 Fort Collins CO 90524
970
484-4552
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here
❑ Report
SWestaxnumber isfw redby.0mnpwtav
Are you paying with your trust account?
❑ Yes
❑ No
Is this a residential or commercial project? 1( Residential ❑ Commercial
If residential, is it: Wingle Family Detached ❑ Condo/townhome (single family attached) 0 Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ ear ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? O Yes ❑ No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building Constructed?
Ifpdar to 1975, you wi// need an asbeestos assessment In submit with this application.
Description of work
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
SuboontracWrw List the company name or Oty of Ft Co//Ins license 9
Electrician Plumber Mechanical` H1309 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 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.
Applicant:
Print Name: An ela Morrow Signature
oats 3/7/*