HomeMy WebLinkAbout4815 BOARDWALK DR - APPLICATIONS - 5/9/2017Fort of
Planning, Development & Transportation
281 N College Ave P 0 Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 22+6134
OVER-THE-COUNTER PERMITS ONLY
This application Is to be used to apply for the following permits on (check all that apply) ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not sere change) 0 Gas Lighter ❑ Gas Log
❑ Heabng Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet 915ve must be EPA certified, provide make, model and
manufacturer)
Complete all applicable information on the application Incomplete applications will not be accepted
Application * d x-4C2141Y
For oIIice we only
Date 5/9/2017
lob Site Address frequrred)
off::} ce Value of Constru on (labor, materials, profit)
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Property Owner Name
Address City/State Zip
Phone
SECUR CARE STORAGE (AVERY HERRERA)
4815 E BOARDWALK DR FORT COLLINS CO 80525
303-842-4656
Applicant Name
Address City/State Zip
Phone
KELLY CANNON 2690 W MAIN ST SUITE C LITTLETON CO 80120
303-816-1888
Contractor
Address Oty/State Zip
Phone
INFINITY RESTORATION
2690 W MAIN ST SUITE C LITTLETON CO 80120
303-816-1888
Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report?
X Here ❑ Report
Sales tax number ,snegmredbyall mnbaciom
Are you paying with your trust account?
❑ Yes I kNo
R-1865
PLEASE CALL ME FOR PAYMENT KELLY @ 303-816-1888
Is this a residential or Commercial project? ❑ Residential ($Commercial
If residential, is it ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant 1R Other (explain) SECUR CARE STORAGE STORAGE UNITS
Is this building 50 years of age or more? ❑ Yes J(No !f yes, you may need to contact Histanc Preservabon
If this is for a demolition permit, what year was the building Constructed?
Ifpnor to 1975, you wd/ need an asbestos assessment to submit with this app//cation
Descnpbon of work 'J�D SQ Li -La Z, +�mcv\
*If lawn sprinkler/backflow preventer, must list licensed plumber If first-time A/C, must list licensed electrician
Subcontractors. Lrst the company name or City of Ft Collins license #
Electrician Plumber Mechanical Roofer Vll�bb Outer
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
Applicants KELLY CANNON 5/
Print Name Signature p 9/2017