HomeMy WebLinkAbout607 ALPERT CT W - APPLICATIONS - 5/4/2018CI of Planning, Development, & Transportation Services
Flirt Collins Community Development & Neighborhood Services
.,` 281 North College Avenue
Fort Collins CO 80524 970 416 2740
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply) ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation X 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 ac epted
PP
A lication # �! SD Jn 3,13 Date t S
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
607 W Alpert Ct $967 50
Property Owner Name Address City/State Zip Phone
Letha Robinson 1812 Lakeshore Cir Fort Collins CO 80525 970-482-9293
Applicant Name Address City/State Zip Phone
Daniel Ormesher
Contractor Address City/State Zip Phone
Independent Plumbing Solutions, Inc 1611 E Lincoln Ave, Unit A, FC, CO 80524 970-566-1377
Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? ❑ Here D(Report
Sales tax number is required by all contractors Are you paying with your trust account? ❑ Yes X No
45189
Is this a residential or commercial project? ❑ Residential ❑ Commercial
If residential, is it ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
ffiI 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 ❑ No If yes, you may need to contact Histonc Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work Replaced 40 gallon natural gas water heater
*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 #
Electrician Plumber M P610 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 _ e
Print Name Daniel Ormesher signature Date
Revised 111232016