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HomeMy WebLinkAbout4900 BOARDWALK DR - APPLICATIONS - 8/11/2017Pianningr Development & TrA nspol'tati'm t �3Wns 281 N. College Ave - P.O. aaoc 58D Fort Collins, CO SM4 - - Phone 970-416-2740 Fax 214-6134 OVER-THE-COUNTER PERMITS ONLY 'this application Is to he used to apply for the following permits only (clieck all that apply). ❑ Air Conditioning 0 Dernolltion (interior non-structural) 0 aecbical Alteration (not service change) ❑ Gas UQhiar 0 Gas Leg . D Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Rooting 0 Sewer Line ❑ Photo -voltaic ❑ Verrtilatior�fater Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA cedi teed, provide matte, model and manufacturer)- - Complete all applicable Information on the application. Incomplete applications vAU not be accepted. Application * ej t'JNA-+53 Date rarofte my only Sob Site Add= (required} Value of ConstrtbetioIn (Ia6or, materials, profit) Address R)� City/state v't✓' —zp Piwmgk 1 v ' e�i� o'Ny TO CD 371-270 Applicant Name Address M/Slits ZIP Phone t�.laa�i .G-•, /L, / t S✓ G CDZ 1?0 29#-3 J 2-- Contractor Uc # Address City/Rate Zip Phone j,O t--Y?t 5+}�7rE Srin`JJi -I."+ Contractor City of Ft Corns Sales lax # 3k.Yccvgf— Are yeu paying taxes here or by report? 0 Here O(AepDrt Saks iaxnumaerKrgt*WbyaAcoaasa = Are you paying with your trust account? jd'Yes ❑ No Is this a residel or aornn►erciai project? js Residential ❑ Commerdal If rewdentfatr to it: ErSingle Family Detached CI condc/townhome (sfnoe ramify attached) i3 Duplex a Nitftifamlly (apartment) o Garage if official, is t: 13 Bank 0 Bar t] Church 0 tioteViviotel 0 Medlml office 13 office 13 Retall ❑ Restaurant © Oilier (elgilain) ! Is this building 50 years of age or more? D Yes G No ffpw youmay�dm m»tacfyLsGpiitprpsenraaYan Tf this is fa a demoNon permit; what year was the bulldbV constructW? rfpnorto 197Z fitw wAYrwdan as kvts a ezm&jttosrebmdt yA* && applieab1w. Descrtptlon of work-ed i D&Uv bleaski-, If fawn sprinbder/baddiow preventar, must Nst licensed plumber. If first-Ume AIC must Est licensed electrician. bcorrtraetormBecitfiLL�theCor�p�Y�nfearQyafFtCa/Bias6cense3� t i dun qund>er tnlwi Roofer p dw hereby aamowledge that I have read Utis appilamon and stain that the above Infbmu on Is Complete and corral I agree to P►y with an requkemerft centOW herein and city ordinances and state km rrgulating building construction. I know dint a errnit is not vaTrd urAR it has been paid and hwed. rn't.b9ante: �(irTYr/I9JS G / e_ Sr .� --.�Date 1311 ! / s d 96b0-ZW0L6 Auodwoo eoiAies uuewlle d60 90'L L 9Z AoN