HomeMy WebLinkAbout605 S MELDRUM ST - APPLICATIONS - 8/12/2016From:
08/12/2016 09:49 0351 P.002
F&t Cattins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER -THE -COULTER 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 "ater 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 #(4'7,2 J Date
For office use only
Is this a residential or commercial project? ❑ Residential ❑ Commercial
If residential, is it: ingle Family Detached Ertondo/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 U-90 If yes, you may need to contact H%stO CPreservation
If this is for a demolition permit, what year was the building constructed?
If pn'or to 1975, you will need an asbestos assessment to submit with this application.
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electriclan.
Subcontractors: Ust the company name or Clty of Ft Collins %ice? #
Electrician Plumber Mechanical Roofer Other
1 hereby acknowledge that I have read this application and state that the above information is complete and correct. 1 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: !1. J
Print Name i_ I' i S� Signatur� o ar`t�'1 Date h