HomeMy WebLinkAbout4436 STARFLOWER DR - APPLICATIONS - 5/31/2017i1311Vt 1_ZQlT l::T MAMFIWT TO:19702246134 FROI%i�41ahVO7234 T-62Z P OEM': F-66?
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Planning, Development & Transportation
C"Of
�InSFor N. College Ave P.O. Box 580
1 ,,7 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). O Air Conditioning
O Demolition (Interior non-structural) O Electrical Alteration (not service change) 0 Gas Lighter ❑ Gas Log
❑ Heating Unit 0 Leon Sprinkler 13 Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation C] Water Heater ❑ Water Line 0 Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all ble inforrrn& io on the application.
kplication # v p4s
� &Nw use Dory
Incomplete applications will not be accepted.
Date
_ _
Value of Construction (labor, materials, profit)
V,
Property Owner Name Address
City/%-ft Zip Phone
0jo 0
�. C11110,420.2 5
Applicant Name Address
Fnri Collins Heating and A or ?OR Commerce
City/state Zip Phone
nr- #4 Fort rniling- rQ R0524 (270) 305-347R
Cortbador Address
city/state Zip Phone
CollinsFan ea and Air 20-8 Comm
Collins 24 552
Contractor City of R. Collins sales Tax #
Are you paying taxes here or by report? ❑ Here 0 Report
Sam
Are you paying with your trust account? ❑ Yes ❑ No
Is this a residential or project? litResidential 0 Commercial
If residential, is it: L1l'Strhgle Family Detached 0 Condo/townhome (single family attached) 0 Duplex
13 Multifamily (apartment) 17 Garage
If commercial, is it: O Bank O Bar ❑ Church 0 Hotel/Motel D Medical office 0 Office D Retail
O Restaurant O Other (explain)
Is this building 50 years of age or more? O Yes O No If yew, you may need to c onfact H&odc Preservation
If this is for a demolition permit;, what year was the bwkhng constructed?
Ifp4w m 1975, yew w ##need an ads asseat imt to submit with this appl4*0A
Dewripdon of work
*If lawn s{xinkler/baddlow preventer, must list 6oenwd plumber. If first-time A/C, must list licensed electrician.
Suboarib twin list dre company name or City of fT L090s Abmw 0
eedriden Number M Roofer
Other
I hereby admowk dp that I have read on application and state that the above information is complete and correct I agree to
comply with aO 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.
Appikeft
Print Name: Angela Morrow Signature
Date