HomeMy WebLinkAbout945 RIDGE RUNNER DR - APPLICATIONS - 11/19/2019F6insCity of I Planning, Development & Transportation
For N. College Ave P.O. Box 580
r't Colt
ins Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER;.PEkMITS ONLY o2SC'
This application is to be used to apply for the followingy (hat N
Demolition (interior non-structural) Electrical Alteration (not service change) all tG s Lighter AiGas Log Wing
Heating Unit Lawn Sprinkler Mobile Home replacement Roofing Sewer Line Photo -
Ventilation Water Heater Water Line Wood/Rellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable iIinform``a^^tionn on the application. incomplete applications will not be accepted.
Application # Date
!vr ofce use only
. P
Job Site Address (required) - :1Calue of Construction (labor, materials, profit)
Property Owner r6e Address City/State
Zip Phone
N
eld I rjvF'gb5?y 2y3 Appli t Name Address Gty�State ZI
< cJl / t) ,; . P Phone
`""" a""' Address . x Ity/State ZIP Phone
9i� 4�.��9 -
Contractor City of Ft Collins Sales Tax # Are y,Q� paying taxes here or by report? Here
Sales tax number isWalred by all contractors � � e rt
Are ynu paying with your trust account? Yes
0
Is this a residential or co I ro'e. 7
esidential Corrlmercial
If residential, is It: Single Family Detached Condo/townhome (single family attached) Duplex
uitifamily (apartmen Garage
If commercial, is it: Bank Bar Church Hotel/Motel Medical office Office Retail
Restaurant Other (explain
Is this building SO years of age or more? Yes No -f yes, you may need to contact Historic Preserva
If this is for a demolition permit, what year was the building constructed? -
tion
IfOM to 1975, you will need an asbestos assessment to submit with ?his app/!cation,
Descriptign of work
�■sue
'•�T �� v 0 vl W i l l u
If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/c, must list licensed electrician.
Subcontractors; List the company name or City of Ft Collins license
jF
Electrician �I�G
lumber Mechanical
� Roofers_ 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:Te_ vit- rl J Signature \-��LL,��
_ Date