HomeMy WebLinkAbout608 SYCAMORE ST - APPLICATIONS - 11/6/2018FCity of Planning, Development, & Transportation Services
ort 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 ❑ 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 infformatioln on the application. Incomplete applications will not be accepted.
Application # 31 1i ®v�ag �7 ti/ Date 11 c �I
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
Law S I`7 oo - 00
Property Owner Name Address City/State Zip Phone
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Applicant Name Address City/State Zip Phone
Contractor Address City/State Zip Phone
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Contractor City of Ft. Colll Sales Tax # Are you paying taxes here or by report? Here ❑ Report
Sales tax number is required by all contactors, Are you paying with your trust account? Yes ❑ No
A loy-1
Is this a residential or commercial project? kResidential ❑ Commercial
If residential, is it: Single Family Detached ❑ Condo/townhome (single family attached) ❑ 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 No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was he building constructed?
Description of work c rtL�n �c; eAnx_
*If lawn sprin r/backflow preventer, must list licensed plumbe . If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license # a
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 rim. r C, V twn n Signatur Date `\ J Lo I1 T(
Revision date 2/6/2017