HomeMy WebLinkAbout4900 BOARDWALK DR - APPLICATIONS - 2/17/2018Mar 20 18,05:55p ellmann service compony 970-482-0416 P.1
City, of Planning, Devekpow* &TramportatlOn
281 N. College Ave P.O. Boot 580
ort Collins Fort Collins, 00 80524
Phone 970-416-ve Fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the folkswing permits only (check all that apply). O Air Condifionhrg
Cl Demolition (interior nonstructural) ❑ Eleculcai AReration (not service change) ❑ Gas Lighter Q Gas Log
O Heating Unit ❑ Lawn Sprinider ❑ Mobile Home replacement ❑ R00%V ❑ Sewer Line ❑ Photo-vorwtc
❑ Ventilation .®-Water Heater ❑ Water Line D Wood/Pellet Stove (must be EPA certified, provide make, model and
manufadtme
ComplOW all aPOUN6le, i�nco
mution on the application. Inmaigt9 applications will not he nemotod.
Application #&��(,1U�6 Date
Four ofte we orNy
Job Site Address (mq&" } Value of consbWetion (labor, materials, Froff')
__:�Lqtz 44 i�-31. 7-
e owner warn S dress 13 15. City/State e4Wfit TipPlmeCf70 -
:cCa0aAb 2AY01- Ll h CO 2)22Z 3?l - ,9 7a
Applicant Narpue Address city/state Zip
33��.
contractor �//m ArJA! ffi52
-fff f Address
Cltvr-ftte zip z-z
45 67emz c / U E 2u — nri co �
ConbactOr City of FL Collins Sales Tax *-362 Zoe Are you paying tam here or by report? 13 Here ,194eport
Salesraxntd7 L:mgrdre�dbya0 airs Are you paying wilt you trust aacmW ,ides O No
Is this a residential or commercial project? -10esiderrdal ❑ commercial
If regdema" k- V'Single. Family Detached ❑ COnQo/townhome (single family attadied) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, Is it ❑ Bank E3 Bar E3 Church ❑ HoWmobei ❑ Medical Office ❑ office o Rtetall
Q Restaurant ❑ Other (explain)
Is this building 50 years of age or more? O Yes 0140 dyes. )wfwyneeipo cuntadh piemwvabb7
If this is for a demolition pwmk, what year vras, the !wilding ocinsMwted?
Ifprior to 1975, You wig need an asbestos assemment to, submAt wgh dais apphtatm
Description of work
�t
*9 lawn sonkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
St orsrLAtMeczanWWYname orCatyofftC3&W6cense#
ridan Plumber _-`i
woofer ppter
I hereby admmWge that I have read this application and state that the above itft,rmtion Is complete and correct. I agree to
comply with all reQuir6Mel contained herein and dty ordinances and sthe laws regulating bLaWMg affldr colon, = know that a .
permit is not rand unM it has been paid and issued.