HomeMy WebLinkAbout624 SKYSAIL LN - APPLICATIONS - 11/8/2017From,
Fort Colt�ns
_ 12/19/2017 08 52 #B44 P 004/004
Planning, Development, & Transportation Services
Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970 416 2740 Fax 970.224 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 service change) ❑ Gas Lighter ❑ Gas Log
ilpeating 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 #�� V 0 onI `i Date 1\\ 61
ForoAice use only
lob Site Address (requbed) Value of Const uctlon (labor, materials, profit)
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Property owner Name Address City/State Zip Phone
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Applicant Name ,Address City/State Tip Phone
Contractor Address City/State Zip Phone
Contractor City of R. Co ins Sales Tax # Are you paying taxes here or by report? %Here ❑ Report
Was ��Ismqu/mAdbya#chmbaavrs: Are you paying with your trust account? VPh'es ❑ No
Is this a residential or commercial project? �tesidential / ❑ Commercial
If residential, is it: �PS!ngle Family Detached ❑ tta
Condo/townhome (single family ached) ❑ Duplex
Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Mobel ❑ Medical office ❑ office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? U Yes O No If yes, you may need to contact HWwc Preservation
If this is for a demolition permit, what year was the building constructed?
Description of wo
*If lawn sprinkler/baddtow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or Lily of Ft Collins Oolanse 0
Electrician 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: //��
Print Name: VN UtM_ G&OL\`y, signature !C�6ZAA"A' _ Date
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