HomeMy WebLinkAbout807 QUAIL RUN - APPLICATIONS - 11/30/2018 (2)Planning, Devdopment tt Trangxwtetlon
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)." Conditioning
❑ Demolition (Interior non-structural) ❑ Electrical.Aiteration (not service change) ❑ Gas Lighter ❑ GasiLog
eating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Une ❑ Photo-vottaic
❑ Ventilation ❑ Water Heater ❑ Water Une ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications willnotbe accepted.
Application # 911bID 16-1S C Date
F-ofte we only 9� I R) 117 5 50 - A=€ 1= I t r� r,r'
Sob Site Add �fiaw a
I - f �'
Value of Construction (labor, matett�!,l p"fd)
I
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Property Owner Na a Address
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/ Zi Rhone
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Applicant Name ) Address
city/State Zip .Phone
Kathi KmKii ey
Broomfield CO
Contractor Address
City/State Zip :Phone
Cooper Heating and Coo 11780 Colman Way 80020 720-361-4245
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here ❑ Report
sane axxmtrrEsrequkMdbyaYC0nVaraxs
Are you paying with your mist account? ❑ Yes ❑ No
Is this a residential or commercial project? U'Residerrdal ❑ Commercial
If residential, is it: -D'Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex,
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office (3 Office ❑ Retail
❑ Rurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes -ZYNo If yes, you may need to aaritactHts >* Pres&vai r
If this is for a demolition permtk what year was the building constructed?
Ifprbar to 1975, ycw MYnteed an a02stos a-ze mnent to suGmlt wti this app/Ic aDan.
of work
*If lawn sprinlder/baddiow prevent er, must list licensed plumber. If first-time A/C, mist list licensed electrician.
Suboontractots List the cm*w7y name or Cty ofR Coflfres lia2 se #
EWcbidan Plumber Medianical Roofer Other
I hereby adorowledge 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 oxtstruction. I (know that a
pemrit is not valid tmtfl it has been paid and issued.
Pit
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