HomeMy WebLinkAbout331 SUNDANCE CIR N - APPLICATIONS - 9/10/2018City of Planning, Development, & Transportation Services
��t Collins 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
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ARoofing ❑ 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 #-?-) 1201103 Date
For office use only
Jo Site Address (required) Value of Construction (labor, materials, profit)
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Property O ner Nam Address City/State Zip Phone
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A pliant Name Address City/State Zip Phone
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Contractor Address City/Stat Zip Phone
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Contractor City of Ft. Co Ins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report
Sales xnur�isrequiredbyallcontactors Are you paying with your trust account? ❑ Yes ❑ No
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Is this a residential or commercial project? Residential ❑ Commercial
If residential, is it: ❑ Single Family Detached ondo/townhome (single family attached) ElDuplex
❑ Multifamily (apartment) Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building SO years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work U
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license # �_ 1
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:: \ l l tj' ` ignature Date
Revision dale 2I612017
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