HomeMy WebLinkAbout4306 VISTA DR - APPLICATIONS - 3/22/2018 (2)From:
03/06/2018 09:23 #934 P.003/003
�ort Collins
Planning, Development, & Transportation Services
Community Development & Neighborhood Services
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),IL2kir Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
4-Guesting Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable informs on on the application.
Application #__ & I ab (814Z
For ofte use only
Incomplete applications will not be accepted.
Date `kAW 3Lzjq 1 rp
Sob Site Address (repuined) Value of Construction (labor,' > ri profit)
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Property Owner Name Address City/State Zip Phone
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Applicant Name Address City/State Zip Phone
Contractor Address City/State Zip Phone
Contractor City of Ft. Co ins Sales Tax # Are you paying taxes here or by report? $13iere ❑ Report
Sales tax number is requlmd by all conbactas Are you paying with your trust account? JPies ❑ No
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Is this a residential or commercial project? Okesidential ❑ Commercial
If residential, is it: qtSingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes O No If yes, you may need to contact Nlstolic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work
*if lawn sprinkler/badcHow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Llst Me company name or City of R Collins lkense #
Electrician Plumber Mechanical 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 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: S usu a;6eK1t r, Signature 1;:�JLji y�9 h Date 74 k4
Revision does 2Bao17