HomeMy WebLinkAbout416 N SHERWOOD ST - APPLICATIONS - 10/5/2018Planning, Devefopinent & Transportatlon
M N. College Ave P.O. Box SO
Fort Collins, CO f30524
Phone 970.416-Z740 Fax 22+61M
OVER-lME-COUMMR MMMITS ONLY
This application Is to be used to apply for the following pemrils: only (check a0 [bat apply). E3 Air Conditioning
® Demolition (Interior non-stnucturai) ❑ Electrical Abration (not service change) 0 Gas Lighter ❑ Gas Log
13 Heating Unit 0 Lawn SprW ter O Mobile Home replacement 0 Roofing ElSewer Line 17 Photo-voltale
❑ VerifUatl n E3 Water Heater t7 Water Line 0 Wood/Pellet Stove (must be EPA cerSfled,. provide make, model and
manufacturar).
Complete all applicable lnfom Mon on the application. Incomplete applicailons will not be accepted.
AppficaUon ilk- Date
Foroftuawi on
Q'T rr
Sob Site Address (ragmW
414 5ke-C
Value of Condon , mawt prom
0
IV- 6o61
1 0-
Property owner Nwe
rid bIWWON
Address
6 S s�
�. � �L Q/` 0tate Sz �
Phone
1 ,S I I51
Applicant Name Address (Sty/State ZIP Phone
t eTS-S'K40 4301"'",gi, �D►• f .�D(. M 9%2L TOO- 45B-6583
Contractor
0� rVE Kv W j ics5
Address '• City/State Zip
J - hi, a.
Phone
-®S8
Contractor City of Ft. Coln Sales Tax
#-
selestaar
Are you paying with your trust aunt?
Yes 00
Is this a re9deritlal or eommerdat pnoject? COWdentlal O Commerdal
If residential, Is It: 17 Single F h* Detached D Condo/townhome (single family a'trad,4 E3 Duplex
13 MuitlfW* (apartment) I] Garage
F comrrmrdat, Is It: O Bank ® Bar 17 Church 0 Hotal/Motel 17 Medhal office 13 offlos 0 Retail
0 Restaurant 0 other (explain)
Is this building lac years of age or more? O Yes 13No If yes, you rntay need toga wtw NsWdc PreseroWon
If this Is for a dentoliiion pemrik what year was the building constructed?
IfprIvr io 1975, you wD/nsed an asbestos assessment to.svb w v.M 9* appOca90A
of
` 9 lam sprtrMerMcIdfow preventer, must list peened plumber: If flrst4irm'A' C, must III licensed electrician.
Subcontractors: List tare company tam or 6lyofFtColl/ras/l=w #
Ptminber M ftokr 3 ,
I hereby admawledge that I have read ibis application and state that the above lnfommtbn is mmplete and correct. I agree to
ownply wpih all requirements cantalned herein and dty ordinances and -stye laws regulating buiding eonstructlon. Y know that a
permit is not valid until It has been paid and Issued. _
Wi�nt111anre: lT�a+t�til✓ 4f�0uF,