HomeMy WebLinkAbout4900 BOARDWALK DR - APPLICATIONS - 3/21/2018ITV o!
_ '1a"'•rllaSr Devtiopmen-t &Transportaon
287 N. College Ave P.O. sox 580
Fort Coffins, Co 8as24
Phone 970-416-2740 Fax 2_7-4-61-3=
'�; ' ram— ii
This application is to be used . apply for the follow "
0 Demolition (interior non-struowmi) [3 ple�i� pj -L S OM (not ss onl char eL an that apply)_ O Air Condoning
O Halting Unit G Lawn Sprinkler ❑ fviobile � tome replacement r? Roofing
9) O Gas
�9�� O has log
Ci Ventilation w r f teeter O �v _ p 9 O Sewer Line. O Photo-:o-voitaio
maniiracalrer).
Water ling n woodlPellEt Stove (must be EPA certlited, provide make, model and
Complete 21I applicable information on the apNioaiorL Incomplete applications will not be dcoeQirc+
Application V � 1 ?c)5 3 ' g, 3 �ZI
Foronce Lm only Date I, j
Job Site r.ejdrese
VatuE Of Cons rUctdon (labor materials, pronL)
Property Own2r Name Address
City Scare ZIP Phone
A¢atrc3nt NameAddress '
f� l� I. n u ci'ISr� jp Phone
i r
Conzrcetnr Address
YY??] City/State 71p Phone
�r1r 11J� i'1 "
-Ts'" T nu City of Ft. Collins Sal Tax f P_ I :;r you paying taxes here or by report? Q Here KReport
ssfes %T number Is caved b-aOavr ctarz.
1 r J Z q Are you ping with your trust account? g Yes O No
is this a residentlai or Commercial ro ect?
-t reydeneaL is lt; p 1 �Residantial Q Commercial
Q Single Family nei^dhed Q Condoltownhome (single family attsched) Q Duplex
Nlulefamily (apartment) O Garage
Ir comrnercfal, is iw C sank is Bar El Church ❑ Hotellp�lotel C7 i4edicai olrca Q 0 G Retail Restaurant 13 Other (explain)
is this building 0 ;gars of age or more? ❑Yes s'_ i+io V yW,, you ffZynead to Coniattff=12Cpfcsa/y
it this isfor a de:n;lition Pern?it, what year Wasthebuilding constructed? appa
IT ,crier to 1975, ,vptl .will need an ash =S azwn:fent to submit wlrh this a,0.D&ad0n.
Description of Work
Tip 12"n sprinkler[badcrlow preventer, must IK licensed plumber. r first erne Ac musi; lisp limmed e(sWpan._
Subcon iTector_ List-jnecomQanyn me orGcyofFcColllnsOcensa
Electic',u _. pryumber
---- »echocad Roofzr
Omer
3 hereby scknowledge,—t have read thus appllcatfon and state drat the above information is complete and cgrrec`� agree to
comply with all requirements contained herzin and city ordinances -and state laws regulating building construction. and Chen, t I agreeow s o a .
perm';:;~ not valid UMVI It, basbeer. paid at G issued.
Applicant:
-
Sigridi.'tE_
Dace ���-