HomeMy WebLinkAbout3281 TWIN HERON CT - APPLICATIONS - 5/19/2017From
05/19/2017 02 32 #609 P 001/001
19g ns
F.Ciof Collins
Planning, Development & Transportation
281 N. College Ave P.O. 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). Lair Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
1R44eating 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 Inffoor(maation on(thhe`'
For office use only application. Incomplete applications will not be accepted
Application # J only
I `T ate
i I —10
lob Site Address (required)
v Value of Construction (labor, materials, profit)
Property Owper Name Address
City/State Zip
Phone
Applicant Name Address
City/State Zip
Phone
Contractor Address
City/State Zip
Phone
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? II(Here
.Report
Sales tar number is required by a// cwwactas
Are you paying wiio your trust account? XYes
13 No
Is this a residential or commercial project? [�-tesldential ❑ Commercial
If residential, is it VSIngle 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 ❑ Other (explain)
Is this building 50 years of age or more7. ❑ Yes ❑ No If yes, you may need to contact Heston Preservatmn
If this Is for a demolition permit, what year was the building constructed?
If prior to 1975, you W11 need an asbestos assessment to submit with this appl/cabbn
Description of
,it lawn sprinkler/baddiow preventer, must list licensed plumber If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or Gty orR Collins license 0
Electrician Plumber Mechaniml 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 regulabng building construction I know that a
permit Is not valid until it has been paid and Issued.
Applicant: ^•
Print Name ` \�C��a? ��:���M Signature. �� .� e i� o
"r..�_ Date L`1