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HomeMy WebLinkAbout919 QUAIL RUN - APPLICATIONS - 6/7/2016F6rt Coltins City, of 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) 0 Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler 0 Mobile Home replacement ❑ Roofing ❑ Sewer Line 0 Photo -voltaic ❑ Ventilation ❑ Water Heater 13 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 #�I b ��Q Date 1 - l—I L9 For office use only Is this a residential or cornrgercial project? E7 Residential 13 Commercial If residential, is it: ©''Single Family Detached 0 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 SO years of age or more? 0 Yes XNo If yes, you may need to contact Historlcpreservation If this is for a demolition permit, what year was the building constructed? Ifpr/or to 1.975, you will need an asbestos assessment to submit witJi this application. Description of work PA04xvf- 25 - 4,a,-es *If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the company name or City of Ft Coffins license Electrician _ 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 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: ✓'lw r4,1 — Signature r� Date I.'d £8£££ZZOL6 6u1100y aey;eaM eaeneS e9t,:80 91• ZO unr