HomeMy WebLinkAbout6213 EAGLE RIDGE CT - APPLICATIONS - 11/13/2018a\-bA-ZL
FCity 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
VlHeating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pallet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable Infomiption qn thg Ifcation. Incomplete applications will not be accepted.
1 `_ Application # C (v\ I Date
For oft usee my
Job Site Address (required) Value of Constnuctlo�a (labor, materials, profit)
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Property Owner ame Address City/State a ZIP Phone
1
Applicant Name Address City/State Zip Phone
Contractor Address City/State Zip Phone
Contractor City of R. Collins Sales Tax # Are you paying taxes here or by report? $Oiere ❑ Report
Sales &wnd20umbe is required by a//mntradors Are you paying with your trust amount? $31(es ❑ No
Is this a residential or commercial project? Wesidential ❑ Commercial
If residential, is it: WSIngle 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? O Yes ❑ No If yes, you may need to contact HkMricPreservation
If this is for a demolition permit, what year was the building constructed?
Description of work
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors:List 05ecompany name orC7tyofFtCollins //cense#
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: t Name:Kw.tkt? G&OOR-1 Signature Date U
Rovialun date areizorr