HomeMy WebLinkAbout415 E LAUREL ST - APPLICATIONS - 11/14/2016Planning, ,Developma.nt w,
281 N. College Ave P.O. Bo:: 41.�V
Fort Collins, CO 80524:
-.-.. ... ?hone 970-115-27.40 F t;., >>=1
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.:,, ;Ificad m is :o ba usad to apply lorthai011oviing permits only (check all that apply). f l Al. (_;:::;l.ti�i•;r
;rliiirrril (inronor anon-str?.1ctLlral) Cl Electrical Alteration (not service change) f:1 Gas Lightal
;iir?;) Llni€ ;Lawn Sprinkle:C! Mobile Home replacement D Roofing 0 Sevier Line C-!'Plnr v)-vr)tt:X.,.
�ili:�itut, ;_ • ? v:.;r,�r I-iaa;c;, ❑ Water Line C7 Wood/Pellet Stove (must be EPA certified. provtd,• i, +li•-: +" ;�'
.;,;;.,i.;Ct ;:il i.ltJlli:::cll:ii illiQ. eaatlOn Url lily application.
Pi,r nrFc,; us�� only
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Incomplete applications vin. 110L b.: •.?..c„u••.i r
Date--�'V`2,+".✓d�' . �
yalue of ConstrudJon (labor,
5141-
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Address C!Ly/Stale 7.111
ress City/State ip
4 ... _ Address CILy/Stitt Zile
ire h
City 4 I c:. �:ullins Sales tax it Arc you paying Mixes here or by report' i_i il'r� ?:•F::
Are ou a in with our ti'LISt' aCCIOLir•tl•? Kp�Y•; ",
....,rill 1h�'r I.,; I0,11.1ill.,I &- al/ conhJCtorS. y p y 9 Y
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;:.., :.:a+i;:llir,,l,n nun nerc:ial project? Isidenbal Cl Commercial -- —^
it: IE-Sittgle I-arnily Detached ❑ Condo/L•ownliome (single family attached)
III Mulff-arnily (apartment) 0 Garage
J Bank r-1 liar ❑ Church III Hotel/Motel 0 Medical office CI Office LJ kc:ii;til
U ilesl.aurant 0 0ther (explain)._-.__-_
Ii:t _50 years, of oge, ur morn? n Yes ❑ No Ifyes, you mayrreed to nanrartl-IrsPrirrr l r;,,,'ivIA'ifi,;:
dairc:i�ion perr�:;t, what year was the building constructed? —..-----.•__-. ..
Wfil M&l an asl7 estos assessment to submit with this app/irarion.
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lit..)! iif l of worl' ."QY_ @._' __: L/ � �-1' l i ---�. S
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r.•r.: ..i,-itaotr/hackflow weventer, must list licensed plumber. Ir first-time A/C, must list licensed eleclr•ucisn .
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i.,;;c�.: s:1.i.••t1/1,,Lr)m17&7yrr,7n7eorCityofFCCn/linslicense
Rooter
dial. 1 IlavL read this application and state that the above infomnatlnn is complew and ccrrr:::.
;,1! rrscluireincrlis rolimined herein and city ordinances and slate laws tegulatirtg building consb'uctin,;. .� iu;aav .:
i>: riot valid ui]'r_•1 it has been paid and issued.
t i ti ,y I t e
'�'i��s.. Signature _ W
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