HomeMy WebLinkAbout328 WEST ST - APPLICATIONS - 2/10/2020City of Planning, Development & Transportadon Services
�Fort Collins Community Development & Neighborhood Services
�-- 281 North Callege Avenue
Fort Collins, CO 80524 Main: 970.4162740 Fax 970.224.6134
OVER -THE -COULTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
0 Demolition (interior nonstructural) ❑ Bectricai Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Healing Unit ❑ Lawn Sprinkter ❑ Mobile Home replacement ❑ Roofing ❑ Sewer tine ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. incomplete applications will not be accepted.
Application #
Fcrolfre rew an/y
Data February 7, 2020
Job Site Address (Required) Value of Construction (labor, materials, profit)
328 West St, Ft Collins, Colorado 80521 $2303.00
Property Owner Name Address City/State ZIP Phone
beligia, Kelly 328 West st Ft Collins, CO 80521 970-388-8283
Applicant Name Address Gty/State Tip Phone
Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632
Contractor Address city/State Zipp Phone
Allen Service 1015 Link Lane Ft Co, CO 80524 484-4841
Contracmr (Sty of Ft. Collins Sales Tax t Are you paying taxes here or by report? ❑Mere ❑ Report
Sa/estarnrmrbe 6-fiW 1r&bydRM7hatlbrs Are you paying with your mist account? VYes ❑ No
10010
Is this a residential or qpmmetdal project? Y, Residential ❑ Commercial
If residential, is it: V Single Family Detached ❑ Condo/t:ownhome (single family attached) ❑ Duplex
❑ Multifamily (aparbnent) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Mote) ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No Byesyvun7ayneeortocmitadifstwkPieswmtfon
If this is for a demolition permit, what year was the building constructed?
Description of work rze wadstfegw/Handrepla with liken wrtl
*If lawn sprinkler/baddiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
subcontractors: List Lhe mmpanyname orQyofltCoMr s licaw 0
9ectr Plumber Medw&af 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 hereln and sty ordbhances and state laws regulating building construction. I know that a
permit is not valid until it has been paid and issued.
Apprreant: Chr6Wui .>:va %s C 2 -i ZD
Print Name: Signature v' `nI h"r �1,�_ Date
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