HomeMy WebLinkAbout4815 BOARDWALK DR - APPLICATIONS - 5/9/2017 (2)Fo t Collins
Planning, Development & Transportadon
281 N College Ave P 0 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 sR7e change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water 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 # ?�oI1j2U q y
For office use only
Date 5/9/2017
Sob Site Address (required)
Value of Construction (labor, materials, profit)
I rd a 1 k- Dr U r i 1.2
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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
City/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 W number is required by all contractor
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 OxCommercial
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 J( Other (explain) SECUR CARE STORAGE STORAGE UNITS
Is this building 50 years of age or more? ❑ Yes i( No If yes, you may need to contact Historic Preservat/on
If this is for a demolition permit, what year was the building constructed?
Ifpnor to 1975, you will need an asbestos assessment to submit wdh this application
Descripti n of work �P — 1�-CJIi�, li�`V� C'1�\= TNM V i 1�
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*If lawn sprinkler/backflow preventer, must list licensed plumber If first-time A/C, must list licensed electrician
Subcontractors List the company name or aty of Ft Coffins //tense #
Dectrician 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 Pont Name KELLY CANNON
5/9/2017