HomeMy WebLinkAbout902 RIDGE RUNNER DR - APPLICATIONS - 9/25/2018Ciof
Fort 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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Aoofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete ail applicable information on the application. Incomplete applications will not %e accepted.
Application # M(blo cb`i q� Date
For office use only
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G Site Address (required) Value of Construction (labor, materials, profit)
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Property Owner Name Address
City/State
Zip
Phone Q i D
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Applicant Name Address
City/State
Zip
Phone
Contractor Lic # Address
City/State
Zip
Phone C-00
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Contractor City of Ft. Collins Sales Tax # q �j lip
Are you paying taxes here or by report? ❑ Here
g Report
Sales tax number Is required by all contractors
Are you paying with your trust account? XYes
❑ No
Is this a residential or commercial project? `zi Residential ❑ Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) I�.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 more? ❑ Yes gkNo Ifyes,'you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work %CA. C,,Ji'fi� owtNf
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first -tame A/C, must list licensed el ctrician.
Subcontractors: List the company name or City of Ft Collins license # )KO ffta t0
Electrician Plumber Mechanical Roofer Other
I hereby acknowledge that I have read this applicatibn 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: ,� ��CL_ J ! / A
Print Name; Signature G'l� Date ( D
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