HomeMy WebLinkAbout630 SMITH ST - APPLICATIONS - 9/30/2016Planning, Developman't 8., "1
28.1 N. College Ave P.O. Do: IXI
Fort Collins, CO 8052-
Phone 970-116-274 0 Fa
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is Zo b:) cis ad A,:) apply ;or tile ifolloviing permits only (check ail that t ap ply). C1 At; I!;
CIDI'l-Stl-LICkiral) 0 Electrical Alteration (not service change) El Gas Lightal
lo
Mobile! -tome replacement El �Roofing IJ Sewei Une Cl 'PI
-:.1wn Sprinkler D Mobile
ill1 L. ertified, provicle_� 1,
L-iWaterLine VV00Cl/Plaffet Stove (must be EPA C
I �W
illi".31-c-T ation on tile application. incomplete appli-ca. tj oils Wil; "Ot ll;G' P; i'
q 1,5 Date
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value ,of C-onstnic7dan A..
ldress
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City/State .1p
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Address City/State Zip
X YOU here here or by reporl'! 1_11. I
CILY Of j--l. Collins Sales Tax li. Are
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Are YOU P,-IY!Iig with your ITLISI:
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L siclential F Commercial
1111,11,11eR: ell Zir ju .!
0 Concloftownhon"O (single farnily attached)
ing C j-al-rilly Detached.16 j: t!, 1:; itIt.jltifarriily (apart:ment) 1:3 Garage
ED Bar D ChUrch Cl Hotel/motel EJ- Medical office E:l Office
0 Restaurant- 0 Other (explain}
ijo ',? �& Ifyi-S, YOU 177aY BOCCI tO Cont'MY. /_I'5f0/ .1i Prrr,':'I
aj-s of aga or rriore 0 YL 1:1 No
ainolli'don P27-1llsltl
� , what year was the bt.lildlng constructed?
1,187tl all 35LA?StI75 a5-5eSS").'ent to SUbMit- With tj7js application.
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UL I %e IF first-time A/C, must list licensed eleGLIT'lilrz
I)revelli.,et-, must list licensecl PiUmber,
CJI, CitY Of 1=t r-i2ilins libensa
Ulna C,'()rjj1_V17y fl,7177t?
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1a11)bvjo(hje LINIL I. have read this application andstate that the above Information is complete Fitld c
eiriciiidcli.yoj-din-cincesaiidst-ritelciwsi-egLifatirigbL]ildlri�-jcor-iiLi-(.ic,'.Ioij. 1' jul 04V
j.,jjq-j z,11 requireinents contained her
lj;t! Lli1:,11 71, has been paid and issued.
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Signature: