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HomeMy WebLinkAbout839 CAMPFIRE DR - APPLICATIONS - 9/19/2019City of Planning, Development, & Transportation Services �F+�ort COtlins Community Development & Neighborhood Services ti— 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) ❑ 13ectrical Alteration (not service change) ❑ Gas Ughter ❑ Gas Log ❑ Heating Uni( 4 Lam Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventil tan Water Heater ❑ Water Line ❑ WoodlPellet Stove (must be EPA certified, provide make, model and manufactu Complete all applicable Information on the application. Incomplete applications will not be accepted. Application # 2I q I I � IA5a— FarafiRr reps only Date September 18, 2019 Sob Site Address (requbed) Value of Construction (labor, materials, profit) 839 Campfire Drive, Fort Collins, Colorado 80524 $4501.00 Property Owner Name Address City/Sialm ap Phone 7odee Seitz PO Box 898 Fraser, CO 80442 303-881-1369 Applicant Name Address city/State Tipp Phone Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632 Contractor Addis Ciiy/State ZiD Phone Allen Service 1015 Link Lane Ft Co, CO 80524 484-4841 Contachor City of FL Collins Sales Tax # Are you paying taxes here or by report? ❑ jiere ❑ Report distar mmtalsraA&edbyagcwb Are you paying with your trustaccount? IWYes ❑No 10010 Is this a residential or Wmmerdal prided? Residential ❑ Commercial If residential, is it V Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar © Church ❑ HotellMotel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? Ci Yes ❑ No Yyes, you may need to contact 1&t�ricP/es5vabnn If this is for a demolition permit, what year was the building constructed? Description of work P " m "`s""' W/H ma replam afth n Ta kim w/H *If lawn sprinkler/baddlow prevents, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: list the company name or01yoff tCa/Lnslirm se 0 Sed idan Plumber 14echanical Roofer Other I hereby admowledge that I have read this application and state that the above information is complete and correct I agree to comply wffli all requirements contained herein and city ordinances and state laws regulating building mnstniction. I know that a petmrt is not valid unti'1 it has been paid and issued. Applicant: Chrf4iL*ia.Eva u Print Name: signature Da11e RMslm.drte2S=7