HomeMy WebLinkAbout629 S HOWES ST - APPLICATIONS - 11/26/2018City of Planning, Development, & Transportation Services
,wort 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
0 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 applicabllie or(atiiojn on the application. Incomplete applications will not be accepted.
Application # 1 I V 1. Date �� l
For office use only .
lob Site Address (required) Value of Corction (labor, materials, profit)
Property Owner Name Address City/State Zip Phone 10�
Y S
Applicant Name Address City/State Zip Phone
Fort Collins Heating & Air 208 Commerce Dr. #4 Fort Collins, CO 80524 970.484.4552
Contractor Address City/State Zip Phone
Fort Collins Heating & Air 208 Commerce Dr. #4 Fort Collins, CO 80524 970.484.4552
Contractor City of R. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ■ Report
Saks fm number Is required by all contractors. Are you paying with your trust account? ■ Yes ❑ No
MID
Is this a residential or commercial project? ❑ Residential 0 Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage �p,94
If commercial, is it: ❑ 0 ❑ Bank Bar ❑ Church 13 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
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or Oty of ft Collins Ikense
Electrician Plumber Mechanical H1309 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: ,��►�nrn'
Print Name:_ l Signature Date
T
Revision date 782017